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Active NPI 1760047112 Individual Practitioner Male Practitioner

Dr. Keith Dineen Wagner , MD

Dermatology • Appleton, WI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Keith Wagner, MD is a certified Dermatology practicing in Appleton, WI. With approximately 11 years of clinical experience since graduating from University Of Texas Medical Branch At Galveston in 2015, Dr. Wagner delivers high-quality medical care to the local community at 3935 N LIGHTNING DR.

Dr. Wagner is affiliated with Forefront Dermatology Sc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

3935 N Lightning Dr

Appleton, WI 549136717

Telephone 9209681790
Fax 9209681794
Associated Practice Facility / Clinic
🏢 Forefront Dermatology, S.c. Facility NPI 1083768253

Medicare Profile & Education

Medical School

University Of Texas Medical Branch At Galveston

Graduation Year

2015

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Appleton, WI

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
11 Yrs -12.0 yrs vs City Avg
City Avg: 23.0 Yrs
State Avg: 22.7 Yrs
Regional Practice Density
6 Specialists

Practicing in Appleton, WI (337 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
75.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wagner (11 Years) 11 Yrs
Appleton Specialty Average (23.0 Years) 23.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths
538 117 $84.00 $6.31
99213 Established patient office or other outpatient visit, typically 15 minutes
315 248 $263.00 $85.16
17000 Destruction of skin growth
190 159 $303.63 $48.63
11102 Tangential biopsy of single skin lesion
143 126 $378.00 $86.48
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
95 95 $321.00 $103.68
96910 Skin application of tar and ultraviolet B or petrolatum and ultraviolet B
91 13 $340.00 $110.80
17110 Destruction of up to 14 skin growths
90 84 $419.00 $105.26
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
67 55 $147.53 $53.01
11103 Biopsy of related skin growth, each additional growth
53 28 $205.00 $46.91
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
36 29 $372.00 $120.43
99202 New patient office or other outpatient visit, typically 20 minutes
19 19 $223.46 $67.85
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
16 16 $474.00 $155.85
69100 Biopsy of ear
15 15 $677.59 $68.29
Q0112 All potassium hydroxide (koh) preparations
13 12 $59.68 $5.71
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm
13 12 $1002.00 $284.11
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm
13 12 $695.89 $147.92
11900 Injection into skin growth, 1-7 growths
12 11 $201.78 $45.00
11104 Punch biopsy, first skin growth
11 11 $475.00 $117.03

Medical Specialties & State Licenses

CMS Verified: 2023-09-11
Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License WI 82425-20

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Hospital & Practice Group Affiliations

Forefront Dermatology Sc

3935 N Lightning Dr, Appleton, WI 549136717

Phone: 9209681790

Secondary Practice Locations

2700 Crooks Ave Ste 101

Kaukauna, WI 541303900

Phone: 9205815561

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
NPI 1053806083

Physician Assistant (Certified), MPAS

Dr. Brent Weed , MD

Dermatology - Dermatopathology

NPI 1104804038

Doctor of Medicine (M.D.)

NPI 1477725141

Doctor of Medicine (M.D.)

NPI 1801802046

Doctor of Medicine (M.D.)

NPI 1972863389

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location July 19, 2023

Registered at 3935 N LIGHTNING DR, APPLETON, WI 549136717 (Tel: 9209681790)

📍
Updated Business Mailing Address July 19, 2023

Registered at 801 YORK ST, MANITOWOC, WI 542204630 (Tel: 9206639008)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 19, 2023

Dermatology (License #82425-20 in WI)

NPI Profile Active May 01, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location May 01, 2019

Registered at 1 HURLEY PLZ, FLINT, MI 485035902 (Tel: 8327380335)

📍
Updated Business Mailing Address May 01, 2019

Registered at 1 HURLEY PLZ, FLINT, MI 485035902

👤
Provider Name / Credentials Updated May 01, 2019

Recorded as KEITH WAGNER, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 01, 2019

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 01, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1760047112
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 01, 2019
Last Update: September 11, 2023
Sole Proprietor: No

Mailing Address

801 York St

Manitowoc, WI 542204630

Phone: 9206639008

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.