Individual provider Active NPI

Steven Richard Hagen, TCHR VIS IMP

  • Specialist
  • Amherst, NY
National Provider Identifier
1184979585
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0007725 Issued in NY
Practice address
700 Sweet Home Rd
Amherst, NY 14226-1444
Phone
(716) 836-7556
Fax
(716) 837-2829
NPI assigned
Jul 23, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0007725 NY Primary

Addresses

Primary practice location

700 Sweet Home Rd
Amherst, NY 14226-1444

Mailing address

700 Sweet Home Rd
Amherst, NY 14226-1444
Phone (716) 836-7556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0007725NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1184979585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SWEET HOME RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261444",
            "telephone_number": "716-836-7556",
            "fax_number": "716-837-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SWEET HOME RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261444",
            "telephone_number": "716-836-7556",
            "fax_number": "716-837-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "STEVEN",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "TCHR VIS IMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "0007725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.