Individual provider Active NPI

Eric K Hage, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Dodge, IA
National Provider Identifier
1326024910
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
113289 Issued in IA
Practice address
802 Kenyon Rd
Fort Dodge, IA 50501-5740
Phone
(515) 573-3101
Fax
(515) 574-6456
NPI assigned
Dec 16, 2005
Last updated
Sep 26, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 113289 IA Primary

Addresses

Primary practice location

802 Kenyon Rd
Fort Dodge, IA 50501-5740

Mailing address

PO Box 310117
Des Moines, IA 50331-0117
Phone (800) 303-7642

Other identifiers 1

IdentifierTypeStateIssuer
0487728MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060217000300 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163437799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Sports Rehab and Professional Therapy Associates IncGroup PAC ID 1658289608, 124 clinicians
Trinity Regional Medical CenterGroup PAC ID 7315858529, 170 clinicians

Practice addresses (Care Compare)

315 W 5TH St
Storm Lake, IA 50588-1743
Phone (712) 732-7724

802 Kenyon Rd
Fort Dodge, IA 50501-5740
Phone (515) 573-3101

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
113289IAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Regional Medical Center Nurse Anesthetist, Certified Registered CurrentSince May 1, 2019 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients

Locations

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

Interoperability endpoints

  • Direct secure messaging: ehage3800@direct.unitypoint.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1326024910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 310117",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503310117",
            "telephone_number": "800-303-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 KENYON RD",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015740",
            "telephone_number": "515-573-3101",
            "fax_number": "515-574-6456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGE",
        "first_name": "ERIC",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "113289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0487728",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Dodge, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.