Individual provider Active NPI

Safeta S Hagen, CRNA

  • Certified Registered Nurse Anesthetist
  • Lorain, OH
National Provider Identifier
1083018071
Registry record updated Oct 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
308794 Issued in OH
Practice address
3700 Kolbe Rd
Lorain, OH 44053-1611
Phone
(440) 323-8515
Fax
(440) 323-7900
NPI assigned
Oct 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2014

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 308794 OH Primary

Addresses

Primary practice location

3700 Kolbe Rd
Lorain, OH 44053-1611

Mailing address

860 E Broad St Ste I
Elyria, OH 44035-6542
Phone (440) 323-8515

Other names 1

  • Sandy Covic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141106002411 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345462370 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elyria Anesthesia IncorporatedGroup PAC ID 7214902170, 64 clinicians

Practice addresses (Care Compare)

3700 Kolbe Rd
Lorain, OH 44053-1611
Phone (440) 323-8515

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
308794OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
Elyria Anesthesia Incorporated CurrentSince Oct 27, 2014 Accepting new patients
Ohio Anesthesia Group, Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2019 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Jan 21, 2024 Accepting new patients
Radius Anesthesia of Ohio, LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

111 Town Square Pl
Ste 420
Jersey City, NJ 07310
Phone (201) 258-4700

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

44 Blaine Ave
Cleveland, OH 44146
Phone (330) 528-3593

11100 Euclid Ave
Cleveland Heights, OH 44106

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

630 E River St
Elyria, OH 44035
Phone (440) 329-7450

860 E Broad St
Ste I
Elyria, OH 44035
Phone (440) 323-8458

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

15345 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 743-8000

200 W Lorain St
Oberlin, OH 44074
Phone (440) 775-1211

Interoperability endpoints

  • Direct secure messaging: shagen33150@ehrdirect.uhhospitals.org

Organizations & group practices 5

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 3

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": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413763200000",
    "number": "1083018071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 E BROAD ST STE I",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356542",
            "telephone_number": "440-323-8515",
            "fax_number": "440-323-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 KOLBE RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531611",
            "telephone_number": "440-323-8515",
            "fax_number": "440-323-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "SAFETA",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-20",
        "last_updated": "2014-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "308794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDY",
            "last_name": "COVIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lorain, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; 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.