Active NPI
Amy Hagen
- Primary Care Nurse Practitioner
- Mankato, MN
National Provider Identifier
1174938880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 185061-5
- Practice address
- 1025 Marsh St
Mankato, MN 56001-4752 - Phone
- (507) 625-4031
- NPI assigned
- Jun 23, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 185061-5 | MN | Primary |
Addresses
Primary practice location
1025 Marsh St
Mankato, MN 56001-4752
Mailing address
320 Grovebrook CT
Mankato, MN 56001-5499
Phone (320) 583-6034
Other practice location 1
201 N Victory Dr
#211
Mankato, MN 56001-5396
Phone (507) 387-5581
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ahagen90176@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 185061-5 | MN | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Health System-St James | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients |
Locations
1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623
301 2nd St NE
New Prague, MN 56071
Phone (952) 758-4431
1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261
Interoperability endpoints
- ahagen90176@ehrdirect.mayoclinicmsg.org
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.
-
- Multi-Specialty Clinic/Center
- Mankato, MN
- NPI 1578545422
-
- Multi-Specialty Clinic/Center
- Saint James, MN
- NPI 1023177730
-
- Critical Access Hospital
- New Prague, MN
- NPI 1124035282
-
- Multi-Specialty Clinic/Center
- Waseca, MN
- NPI 1518494251
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fairmont, MN
- NPI 1821066499
-
- Critical Access Hospital
- New Prague, MN
- NPI 1124035282
-
- General Acute Care Hospital
- Mankato, MN
- NPI 1154302487
-
- Critical Access Hospital
- Saint James, MN
- NPI 1639198732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1174938880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 GROVEBROOK CT",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015499",
"telephone_number": "320-583-6034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 MARSH ST",
"city": "MANKATO",
"state": "MN",
"postal_code": "560014752",
"telephone_number": "507-625-4031"
}
],
"practiceLocations": [
{
"address_1": "201 N Victory Dr",
"address_2": "#211",
"address_purpose": "LOCATION",
"city": "Mankato",
"state": "MN",
"postal_code": "560015396",
"country_code": "US",
"telephone_number": "507-387-5581",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HAGEN",
"first_name": "AMY",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-23",
"last_updated": "2020-10-26",
"certification_date": "2020-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "MN",
"license": "185061-5",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ahagen90176@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "1025 Marsh St",
"city": "Mankato",
"state": "MN",
"country_code": "US",
"postal_code": "560014752",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.