Individual provider Active NPI

Kristoffer L Hagen, CRNA

  • Certified Registered Nurse Anesthetist
  • Oshkosh, WI
National Provider Identifier
1053752782
Registry record updated Jul 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
160648-30 Issued in WI
Practice address
500 S Oakwood Rd
Oshkosh, WI 54904-7944
Phone
(920) 223-2000
NPI assigned
Jul 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 160648-30 WI Primary

Addresses

Primary practice location

500 S Oakwood Rd
Oshkosh, WI 54904-7944

Mailing address

3420 Jackson St
Suite E
Oshkosh, WI 54901-8144
Phone (920) 426-2211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130806000821 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153563028 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Racine Anesthesia Services LLCGroup PAC ID 8628103777, 81 clinicians

Practice addresses (Care Compare)

500 S Oakwood Rd
Oshkosh, WI 54904-7944
Phone (920) 223-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Racine Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 15, 2024 Accepting new patients
Anesthesia Services of the Fox Valley SC CurrentSince Aug 1, 2023 Accepting new patients
Association of Hospital Anesthesiologists SC CurrentSince Dec 1, 2022 Accepting new patients
Laboratory Corportation of America Holdings Past Accepting new patients

Locations

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

1616 N Casaloma Dr
#200
Appleton, WI 54913
Phone (314) 550-0188

4648 W Spencer St
Appleton, WI 54914
Phone (920) 731-7557

736 Ford St
Kimberly, WI 54136

1550 Midway Pl
Menasha, WI 54952
Phone (920) 727-8030

1550 Midway Pl
Ste 100
Menasha, WI 54952
Phone (214) 726-6042

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

1380 Tullar Rd
Neenah, WI 54956
Phone (920) 205-0379

130 2nd St
#A107
Neenah, WI 54956

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

3420 Jackson St
Ste E
Oshkosh, WI 54901
Phone (920) 426-2211

501 Doctors Ct
Oshkosh, WI 54901
Phone (608) 829-7777

500 S Oakwood Rd
Oshkosh, WI 54904
Phone (920) 223-0501

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1053752782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 JACKSON ST",
            "address_2": "SUITE E",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549018144",
            "telephone_number": "920-426-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S OAKWOOD RD",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047944",
            "telephone_number": "920-223-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "KRISTOFFER",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-10",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "160648-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.