Individual provider Active NPI

Kevin Lagor, NP-C

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1205297033
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP029565 Issued in CA
Practice address
1563 Mission St
San Francisco, CA 94103-2543
Phone
(415) 762-1550
Fax
(415) 865-0119
NPI assigned
Mar 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP029565 CA Primary

Addresses

Primary practice location

1563 Mission St
San Francisco, CA 94103-2543

Mailing address

1563 Mission St
San Francisco, CA 94103-2543
Phone (415) 762-1550

Other identifiers 1

IdentifierTypeStateIssuer
NPF95003917OtherCASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180516003043 CA Practitioner - Nurse Practitioner 9931464120 Reassigns benefits to 2 organizations
I20240526000031 PA Practitioner - Nurse Practitioner 9931464120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.2 of 100Reported as group
Quality
61.12
Promoting interoperability
99
Improvement activities
40
Cost
83.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP029565PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Philadelphia Fight CurrentSince Apr 21, 2024 Accepting new patients
Lifelong Medical Care CurrentSince May 2, 2018 Accepting new patients
Lifelong Medical Care CurrentSince May 2, 2018 Accepting new patients
Philadelphia Fight CurrentSince Apr 21, 2024 Accepting new patients

Locations

2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

1233 Locust St
Ste 500
Philadelphia, PA 19107
Phone (215) 790-1788

1207 Chestnut St
Fl 3
Philadelphia, PA 19107
Phone (215) 564-6388

1233 Locust St
Fl 3
Philadelphia, PA 19107
Phone (267) 725-0252

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.

NPI Registry JSON

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1205297033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032543",
            "telephone_number": "415-762-1550",
            "fax_number": "415-865-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1563 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032543",
            "telephone_number": "415-762-1550",
            "fax_number": "415-865-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGOR",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-07",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "SP029565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "NPF95003917",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.