Individual provider Active NPI

Elnora Michelle Hagans, N.P.

  • Registered Nurse
  • Minneapolis, MN
National Provider Identifier
1376844316
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R1159183 Issued in MN
Practice address
5101 Minnehaha Ave
Minneapolis, MN 55417-1647
Phone
(612) 728-7463
NPI assigned
Nov 8, 2010
Last updated
Nov 8, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R1159183 MN Primary

Addresses

Primary practice location

5101 Minnehaha Ave
Minneapolis, MN 55417-1647

Mailing address

3111 Portland Ave
Minneapolis, MN 55407-1528
Phone (612) 823-7789

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
I20160405001056 MN Practitioner - Nurse Practitioner 9032416102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5101 Minnehaha Ave
Minneapolis, MN 55417-1647
Phone (612) 548-5709

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1159183MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
State of Minnesota-Minnesota Management and Budget CurrentSince Sep 20, 2015 Accepting new patients
State of Minnesota-Minnesota Management and Budget Current Accepting new patients
State of Minnesota-Minnesota Management and Budget CurrentSince Sep 20, 2015 Accepting new patients

Locations

5101 Minnehaha Ave
Minneapolis, MN 55417
Phone (612) 548-5709

5101 Minnehaha Ave
Bldg 10
Minneapolis, MN 55417

56 Outer Dr
Silver Bay, MN 55614
Phone (218) 226-6300

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 3

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": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1376844316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 PORTLAND AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071528",
            "telephone_number": "612-823-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 MINNEHAHA AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171647",
            "telephone_number": "612-728-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGANS",
        "first_name": "ELNORA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-08",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R1159183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.