Individual provider Active NPI

Benjamin James Hageman, PA-C

  • Physician Assistant
  • Sartell, MN
National Provider Identifier
1336790179
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13142 Issued in MN
Practice address
2251 Connecticut Ave S
Sartell, MN 56377-2583
Phone
(320) 253-5220
NPI assigned
Sep 23, 2019
Last updated
Oct 31, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13142 MN Primary

Addresses

Primary practice location

2251 Connecticut Ave S
Sartell, MN 56377-2583

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516
Phone (320) 253-5220

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191106002141 MN Practitioner - Physician Assistant 0042542334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simplicity Health PAGroup PAC ID 1557617354, 16 clinicians

Practice addresses (Care Compare)

3290 42ND Ave S
Saint Cloud, MN 56301-6251
Phone (320) 227-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13142MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic CurrentSince Aug 1, 2020 Accepting new patients
Group Health, Inc. CurrentSince Nov 4, 2019 Accepting new patients
Simplicity Health PA CurrentSince Jan 5, 2026 Accepting new patients
Group Health, Inc. CurrentSince Nov 4, 2019 Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

12800 Rolling Ridge Rd
Becker, MN 55308
Phone (763) 261-7000

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1555 Northway Dr
Ste 100
Saint Cloud, MN 56303
Phone (320) 240-3114

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

3290 42nd Ave S
Saint Cloud, MN 56301
Phone (320) 227-5000

3290 42nd Ave S
Ste 100
Saint Cloud, MN 56301
Phone (320) 227-5000

2251 Connecticut Ave S
Sartell, MN 56377
Phone (320) 253-5220

Interoperability endpoints

  • Direct secure messaging: bhageman489987@direct.centracare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1336790179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "320-253-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 CONNECTICUT AVE S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772583",
            "telephone_number": "320-253-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEMAN",
        "first_name": "BENJAMIN",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

Verify at the official NPI Registry.