Individual provider Active NPI

Elizabeth Marie Hagan, P.A

  • Surgical Physician Assistant
  • Jupiter, FL
National Provider Identifier
1205160983
Registry record updated Sep 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA 9105150 Issued in FL
Practice address
600 University Blvd Ste 101
Jupiter, FL 33458-2778
Phone
(561) 776-7676
Fax
(561) 776-7585
NPI assigned
Sep 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA 9105150 FL Primary

Addresses

Primary practice location

600 University Blvd Ste 101
Jupiter, FL 33458-2778

Mailing address

600 University Blvd Ste 101
Jupiter, FL 33458-2778
Phone (561) 776-7676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100129000578 FL Practitioner - Physician Assistant 2769525781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert J. Anderson MD PAGroup PAC ID 3274590831, 2 clinicians

Practice addresses (Care Compare)

600 University Blvd
Jupiter, FL 33458-2778
Phone (561) 776-7676

Hospital & facility affiliations

  • Palm Beach Gardens Medical Center Hospital, Palm Beach Gardens, FL, CCN 100176
  • Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253

Merit-based Incentive Payment System (MIPS)

Final score
77.72 of 100Reported as group
Quality
64.45
Improvement activities
40
Cost
62.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 9105150FLMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: ehagan19973@jupitermedicalcenter.direct-ci.com

Organizations & group practices 1

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 2

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": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254096000000",
    "number": "1205160983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 UNIVERSITY BLVD STE 101",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582778",
            "telephone_number": "561-776-7676",
            "fax_number": "561-776-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 UNIVERSITY BLVD STE 101",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582778",
            "telephone_number": "561-776-7676",
            "fax_number": "561-776-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "P.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2009-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA 9105150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.