Individual provider Active NPI

Thomas V O'Hagan, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Traverse City, MI
National Provider Identifier
1124273958
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
4301103987 Issued in MI
Practice address
4045 W Royal Dr
Traverse City, MI 49684-8965
Phone
(231) 935-0900
NPI assigned
Nov 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 125-053236 IL
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 4301103987 MI Primary

Addresses

Primary practice location

4045 W Royal Dr
Traverse City, MI 49684-8965

Mailing address

4045 W Royal Dr
Traverse City, MI 49684-8965
Phone (231) 935-0900

Other practice location 1

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7777

Other practice location 2

1105 Sixth St
Traverse City, MI 49684-2345
Phone (231) 779-0320

Other practice location 3

8872 Professional Dr Ste B
Cadillac, MI 49601-8482
Phone (231) 779-0320

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address 0566.0001@direct.gloc.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131002000603 MI Practitioner - Orthopedic Surgery 4183858269 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
New York Medical College, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Great Lakes Orthopaedic Center PCGroup PAC ID 1759371826, 36 clinicians

Practice addresses (Care Compare)

1400 Mercy Dr
Suite 100
Muskegon, MI 49444-1833
Phone (231) 733-1326

4045 W Royal Dr
Traverse City, MI 49684-8965
Phone (231) 935-0900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement14
Lower limb (leg) arthroscopy (minimally invasive joint repair)13
Upper limb (arm) arthroscopy (minimally invasive joint repair)37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125-053236ILMDOrthopaedic Surgery Physician
4301103987MIMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates of Muskegon, PC Orthopaedic Surgery CurrentSince Apr 1, 2026 Accepting new patients
Kalkaska Memorial Health Center CurrentSince Apr 8, 2022 Accepting new patients
Great Lakes Orthopaedic Center, P.C. Orthopaedic Surgery CurrentSince Sep 1, 2013 Accepting new patients
Kalkaska Memorial Health Center CurrentSince Apr 8, 2022 Accepting new patients
Munson Healthcare Cadillac CurrentSince Feb 1, 2018 Accepting new patients
Orthopaedic Associates of Muskegon, PC Orthopaedic Surgery CurrentSince Apr 1, 2026 Accepting new patients
Kalkaska Memorial Health Center Current Accepting new patients
Munson Medical Center CurrentSince Mar 31, 2021 Accepting new patients
Munson Healthcare Cadillac Orthopaedic Surgery CurrentSince Feb 1, 2018 Accepting new patients
Munson Medical Center Current Accepting new patients
Munson Medical Center CurrentSince Mar 31, 2021 Accepting new patients
Munson Healthcare Cadillac Current Accepting new patients

Locations

3782 Momentum Pl
Chicago, IL 60689

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

8872 Professional Dr
Ste B
Cadillac, MI 49601
Phone (231) 779-0320

419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500

1400 Mercy Dr
Ste 100
Muskegon, MI 49444
Phone (231) 733-1326

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

4045 W Royal Dr
Traverse City, MI 49684
Phone (231) 935-0900

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

3663 N Country Dr
Traverse City, MI 49684
Phone (231) 252-1228

401 Munson Ave
Traverse City, MI 49686
Phone (231) 933-3283

Interoperability endpoints

  • Direct secure messaging: thomas.ohagan.1@27291.direct.athenahealth.com
  • Direct secure messaging: tohagan@direct.mhc.net

Organizations & group practices 12

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": "1227139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1124273958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 W ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848965",
            "telephone_number": "231-935-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 W ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848965",
            "telephone_number": "231-935-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "419 S Coral St",
            "address_purpose": "LOCATION",
            "city": "Kalkaska",
            "state": "MI",
            "postal_code": "496462503",
            "country_code": "US",
            "telephone_number": "231-258-7777",
            "fax_number": "231-258-7786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1105 Sixth St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842345",
            "country_code": "US",
            "telephone_number": "231-779-0320",
            "fax_number": "231-779-1367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8872 Professional Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496018482",
            "country_code": "US",
            "telephone_number": "231-779-0320",
            "fax_number": "231-779-1367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'HAGAN",
        "first_name": "THOMAS",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-20",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "125-053236",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MI",
            "license": "4301103987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "0566.0001@direct.gloc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "4045 W Royal Dr",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496848965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.