Jeffrey Brooks Hagen, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

0962 Issued in SD

Practice address

3331 N 161St Ter
Omaha, NE 68116-6423

Phone

(402) 690-4357

NPI assigned

Dec 27, 2022

Last updated

Dec 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1356054126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3331 N 161ST TER",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681166423",
            "telephone_number": "402-690-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3331 N 161ST TER",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681166423",
            "telephone_number": "402-690-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "JEFFREY",
        "middle_name": "BROOKS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SD",
            "license": "0962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven V Hagan, M.D.
• Jolynn Hagedorn
• Kerry Elizabeth Hagedorn, DO
• Mark Hagedorn
• Kayla Marie Hagel
• Kenneth J. Hagen Jr., DDS
• Marissa Grace Hagen, PLMHP
• Vicki L Hagen
• Jill M. Hagenkord, M.D.
• Lori Louise Hagensen, C.O.T.

• Anatomic Pathology & Clinical Pathology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Anatomic Pathology & Clinical Pathology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.