Individual provider Active NPI

Michael Anthony O'Hagan, P.A.

  • Medical Physician Assistant
  • Watertown, NY
National Provider Identifier
1346579448
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
013717 Issued in NY
Practice address
20053 Summit View Blvd Ste 1
Watertown, NY 13601-2170
Phone
(315) 755-2560
Fax
(315) 257-6610
NPI assigned
Dec 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 013717 NY Primary

Addresses

Primary practice location

20053 Summit View Blvd Ste 1
Watertown, NY 13601-2170

Mailing address

20053 Summit View Blvd Ste 1
Watertown, NY 13601-2170
Phone (315) 755-2560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100111000522 NY Practitioner - Physician Assistant 7618018730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Jill M Laureano Surber DO PCGroup PAC ID 9335463405, 5 clinicians

Practice addresses (Care Compare)

20053 Summit View Blvd
Suite 1
Watertown, NY 13601-2170
Phone (315) 755-2560

Hospital & facility affiliations

  • Samaritan Medical Center Hospital, Watertown, NY, CCN 330157
  • Lewis County General Hospital Hospital, Lowville, NY, CCN 331317
  • Carthage Area Hospital, Inc Hospital, Carthage, NY, CCN 331318
  • River Hospital Clinics Hospital, Alexandria Bay, NY, CCN 331309

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013717NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eos Medical Group PC Past Accepting new patients
Sharon Emergency Medicine PC Medical Past Accepting new patients
Hudson Valley Emergency Medicine PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mo'hagan@fmonny.medentdirect.com

Organizations & group practices 4

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 7

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": "1261094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1346579448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20053 SUMMIT VIEW BLVD STE 1",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012170",
            "telephone_number": "315-755-2560",
            "fax_number": "315-257-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20053 SUMMIT VIEW BLVD STE 1",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012170",
            "telephone_number": "315-755-2560",
            "fax_number": "315-257-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HAGAN",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-18",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "013717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.