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Kristina M Wagner

Internal Medicine

Allopathic & Osteopathic Physicians

775 S Arlington Ave, Harrisburg, PA 17109-5002

PECOS Enrollment

This provider is enrolled in PECOS as KRISTINA WAGNER.

Based on the most recent information from CMS, provider Kristina M Wagner is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 15 days ago.

Profile Details

Provider ID
1730128588
Provider Type
Individual
Full Name
Wagner, Kristina M
Title
Dr.
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
6/6/2006
Last Updated
4/17/2025

Contact Information

Practice Location

775 S Arlington Ave, Harrisburg, PA 17109-5002

(717) 782-5905

(717) 782-5908

Mailing Location

775 S Arlington Ave, Harrisburg, PA 17109-5002

(717) 782-5905

(717) 782-5908

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License MD051034L Pennsylvania
Code 208000000X	Description Pediatrics Allopathic & Osteopathic Physicians	License MD051034L Pennsylvania

Provider Identifiers

ID	Description	Issuer
ID 001712096	Description Medicaid	Issuer Unlisted Pennsylvania

Kristina M Wagner

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Prats, Andrea

Nowakowski, Kevin Matthew

Dailey, Elena R

Jeffrey J Backenstoes Do Pc

Eckman, Charles Richard

Alsaidy, Alia

Jhajj, Manjit Kaur

Hettick Internal Medicine

Backenstoes, Jeffrey John

Barasch, Aaron Charles