Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Amanda Nicole Wagner , PA

Physician Assistant β€’ Gainesville, GA

Active NPI 1043096142 Individual Practitioner Female Practitioner Accepts Medicare assignment
Practice location in NPPES

743 Spring St Ne
Gainesville, GA 305013715

Call 7702199000 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

743 Spring St Ne

Gainesville, GA 305013715

Telephone 7702199000
Organization at the Same NPPES Address or Phone
Northeast Georgia Medical Center, Inc. Facility NPI 1427055821

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Buford, GA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

CMS Doctors and Clinicians lists 1 group name: Northeast Georgia Physicians Group Inc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2024

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

Years since graduation

2 years (graduated 2024)

CMS Doctors and Clinicians data list 2024 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Amanda Wagner has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Amanda Wagner as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Gainesville and Georgia

109 active clinicians are listed under Physician Assistant with a practice address in Gainesville, GA (4,665 in Georgia).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Gainesville

13.8% of these 109 clinicians have the CMS telehealth indicator.

77.1% of these 109 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-09-15
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES GA 12940

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Georgia Composite Medical Board.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20251030004243

Enrollment State Jurisdiction

GA

PECOS Control ID

3476042219

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Northeast Georgia Physicians Group Inc

743 Spring Nest, Gainesville, GA 305013715

Phone: 7702196000

Northeast Georgia Physicians Group Inc

597 S Enota Dr Ne, Gainesville, GA 305012545

Phone: 7702197777

Secondary Practice Locations

2129 Friendship Rd

Buford, GA 305192600

Phone: 7707155978

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

39 listed
Dr. Richard Adams , DO

Student in an Organized Health Care Education/Training Program

NPI 1164279741

Doctor of Osteopathic Medicine (D.O.)

Neha Agrawal

Radiology - Diagnostic Radiology

NPI 1093058562
NPI 1073891164

Doctor of Osteopathic Medicine (D.O.)

Dr. Vijayamala Bondugula , MD

Psychiatry & Neurology - Neurology

NPI 1053526871

Doctor of Medicine (M.D.)

NPI 1154321248

Doctor of Medicine (M.D.)

Dr. Donna Cota , DO

Internal Medicine - Critical Care Medicine

NPI 1194145862

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
πŸ“
Updated Practice Location September 15, 2025

Registered at 743 SPRING ST NE, GAINESVILLE, GA 305013715 (Tel: 7702199000)

πŸ“
Updated Business Mailing Address September 15, 2025

Registered at PO BOX 742616, ATLANTA, GA 303742616

πŸ‘€
Provider Name / Credentials Updated September 15, 2025

Recorded as AMANDA WAGNER, PA

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 15, 2025

Physician Assistant (license number reported to NPPES: GA 12940)

πŸ“
Updated Practice Location June 09, 2025

Registered at 2129 FRIENDSHIP RD, BUFORD, GA 305192600 (Tel: 7707155978)

βœ…
NPI Profile Active September 05, 2023

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 05, 2023

Registered at 9057 LEXINGTON CT, BRASELTON, GA 305173470 (Tel: 7707155978)

πŸ“
Business Mailing Address (Initial Record) September 05, 2023

Registered at 9057 LEXINGTON CT, BRASELTON, GA 305173470

πŸ‘€
Provider Name / Credentials (Initial Record) September 05, 2023

Recorded as AMANDA WAGNER

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 05, 2023

Physician Assistant

🟒
Initial NPI Registration & Enumeration September 05, 2023

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1043096142
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 05, 2023
Last Update: September 15, 2025
Sole Proprietor: No

Other Physician Assistants in Gainesville

All Physician Assistants in Gainesville

Mailing Address

Po Box 742616

Atlanta, GA 303742616

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.