Marjorie L Van Der Hagen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9413 Issued in MN

Practice address

7373 France Ave S
Suite 312
Edina, MN 55435-4534

Phone

(952) 832-0076

Fax

(952) 832-9881

NPI assigned

Aug 11, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078

Merit-based Incentive Payment System (MIPS)

Final score

91.79 of 100Reported as group

Quality

95.08

Improvement activities

40

Cost

81.67

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Infinite Health Collaborative, PA

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1164474250
  Medicare reassignment Care Compare group NPD
• Infinite Health Collaborative, PA

  • Durable Medical Equipment & Medical Supplies
  • Hudson, WI
  • NPI 1568840916
  NPD
• Infinite Health Collaborative, PA

  • Durable Medical Equipment & Medical Supplies
  • River Falls, WI
  • NPI 1144608589
  NPD (past)

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

• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1699752915
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1932260833
  Care Compare affiliation

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1063423366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 WAYZATA BLVD",
            "address_2": "SUITE 900",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261728",
            "telephone_number": "952-512-5600",
            "fax_number": "952-512-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 FRANCE AVE S",
            "address_2": "SUITE 312",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354534",
            "telephone_number": "952-832-0076",
            "fax_number": "952-832-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DER HAGEN",
        "first_name": "MARJORIE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "73B61VA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP45664",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "114933",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "969991018909",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "12339E948",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Katherine Valiant, MSN, APRN, CCRN
• Valley Counseling & Clinical Psychology Inc
• Jenna Van Beck
• Abigail Van Egdom, LMFT
• Carrie Jo Van Overbeke, NP-C
• Dianne Van Ravenswaay, CRNA
• Michelle Van Ryn, LAMFT
• John W. Van Tassel, MD

• Physician Assistant in Edina, MN
• Providers in Edina, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.