Doctor profile · Federal record
Dr. Jack Wagoner, M.D.
Surgery Physician (CMS: General Surgery) · Sycamore, IL
- NPI 1518979665
- Accepts Medicare
- MIPS 91.3 / 100 · 2023
- 33 yrs in practice
- Male
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
1850 Gateway Dr
Sycamore, IL 601783192
(815) 758-8671
fax (815) 758-5610
Credentials & registration
- NPI registered
- August 2006 — 20 yrs on file
- Profile last updated
- June 11, 2012
- Year of graduation
- 1993 — 33 yrs since
- Specialty taxonomy
- 208600000X — NUCC code
- State license (1)
- Illinois #036-100314
- Medicaid
- IL #036100314
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1518979665. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
623
Distinct HCPCS
10
Medicare allowed
$78,936
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
99232 |
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 220 | 70 | $79 | |
99214 |
Established patient office or other outpatient visit, 30-39 minutes | 73 | 61 | $123 | |
45380 |
Biopsy of large bowel using a flexible endoscope | 62 | 62 | $149 | |
99222 |
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 55 | 52 | $130 | |
43239 |
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 38 | 37 | $78 | |
99203 |
New patient office or other outpatient visit, 30-44 minutes | 33 | 33 | $107 | |
99213 |
Established patient office or other outpatient visit, 20-29 minutes | 31 | 29 | $88 | |
99204 |
New patient office or other outpatient visit, 45-59 minutes | 29 | 29 | $160 | |
45385 |
Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 20 | 20 | $251 | |
99231 |
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 19 | 12 | $50 |
In context: peer comparison
Among 1 peers in Sycamore Surgery Physician, average services per provider: 47. This provider delivers 13× the peer median.Open Payments
Industry payments received
All-time total
$4,583
Transactions
5
Manufacturers
4
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Intuitive Surgical, INC. | 2 | $4,150.00 | |
| Abbott Laboratories | 1 | $228.00 | |
| Si-Bone, INC. | 1 | $177.12 | |
| Medtronic, INC. | 1 | $27.57 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
232
Patients
95
Total drug cost
$3,532
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Pantoprazole Sodium | Generic | 79 | 27 | $1,186 |
| Tramadol Hcl | Generic | 52 | 52 | $96 |
| Famotidine | Generic | 51 | 16 | $1,593 |
| Levothyroxine Sodium | Generic | 14 | 0 | $280 |
| Omeprazole | Generic | 13 | 0 | $235 |
| Lactulose | Generic | 12 | 0 | $125 |
| Gabapentin | Generic | 11 | 0 | $17 |
Hospital affiliations
Frequently asked questions
What is Dr. Jack Wagoner's medical specialty?
Dr. Jack Wagoner practices Surgery Physician in Sycamore, IL.
Where does Dr. Jack Wagoner practice?
Dr. Jack Wagoner practices at 1850 Gateway Dr, Sycamore, IL 601783192. Office phone: 8157588671.
What is Dr. Jack Wagoner's NPI?
Dr. Jack Wagoner's National Provider Identifier (NPI) is 1518979665, issued by NPPES.
Does Dr. Jack Wagoner accept Medicare assignment?
Yes. Dr. Jack Wagoner accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Jack Wagoner commonly perform?
Top Medicare-reported procedures in 2023: Subsequent hospital care with moderate levelof medical decision making (HCPCS 99232); Established patient office or other outpatient visit (HCPCS 99214); Biopsy of large bowel using a flexible endoscope (HCPCS 45380). Source: CMS Medicare Physician & Other Practitioners file.