Individual provider Active NPI

Elise Marie Hagen, MD

  • Obstetrics & Gynecology Physician
  • Rhinebeck, NY
National Provider Identifier
1366700221
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
265815 Issued in NY
Practice address
6734 Route 9
Rhinebeck, NY 12572-3724
Phone
(845) 231-5600
Fax
(845) 202-6713
NPI assigned
Apr 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 265815 NY Primary

Addresses

Primary practice location

6734 Route 9
Rhinebeck, NY 12572-3724

Mailing address

110 S Bedford Rd
Caremount Medical PC
Mount Kisco, NY 10549-3446
Phone (914) 241-1050

Other identifiers 1

IdentifierTypeStateIssuer
03474971MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120821000191 NY Practitioner - Obstetrics/Gynecology 4587811948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York at Stony Brook, School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

Hospital & facility affiliations

  • Northern Dutchess Hospital Hospital, Rhinebeck, NY, CCN 330049
  • Vassar Brothers Medical Center Hospital, Poughkeepsie, NY, CCN 330023
  • Healthalliance Hospital Marys Avenue Campus Hospital, Kingston, NY, CCN 330224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
265815NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Jan 1, 2015 Accepting new patients
Optum Medical Care, P.C. CurrentSince Jan 1, 2015 Accepting new patients
Mount Kisco Medical Group Obstetrics & Gynecology Past Accepting new patients
Northern Dutchess Hospital Past Accepting new patients

Locations

600 Westage Business Ctr Dr
#D
Fishkill, NY 12524

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

6734 Route 9
Rhinebeck, NY 12572
Phone (845) 876-3202

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: ehagen143124@direct.optum.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 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": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1366700221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S BEDFORD RD",
            "address_2": "CAREMOUNT MEDICAL PC",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493446",
            "telephone_number": "914-241-1050",
            "fax_number": "914-242-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6734 ROUTE 9",
            "city": "RHINEBECK",
            "state": "NY",
            "postal_code": "125723724",
            "telephone_number": "845-231-5600",
            "fax_number": "845-202-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "ELISE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "265815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03474971",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rhinebeck, NY

Sources for this page

Verify at the official NPI Registry.