Michael Hagstrom, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036148007 Issued in IL

Practice address

1 Kish Hospital Dr
Dekalb, IL 60115-9602

Phone

(815) 766-7334

Fax

(815) 766-9768

NPI assigned

May 9, 2016

Sex

Male

Sole proprietor

No

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

Enrolled in IL

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

Specialty

Emergency Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286
• Valley West Community Hospital Hospital, Sandwich, IL, CCN 141340
• Alexian Brothers Medical Center 1 Hospital, Elk Grove Village, IL, CCN 140258

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

97.45

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

95.19 of 100Reported as apm

Quality

83.05

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Northwestern Medical Faculty Foundation

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314
  Medicare reassignment Care Compare group NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Elgin, IL
  • NPI 1912283110
  Medicare reassignment Care Compare group
• Aurora Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Yorkville, IL
  • NPI 1407379423
  Medicare reassignment NPD
• Central Dupage Emergency Physicians, PC

  • Emergency Medicine Physician
  • Winfield, IL
  • NPI 1619074028
  Medicare reassignment
• Aurora Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Aurora, IL
  • NPI 1508389628
  NPD
• Northwestern Medical Faculty Foundation

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alexian Brothers Medical Center

  • General Acute Care Hospital
  • Elk Grove Village, IL
  • NPI 1265577191
  Care Compare affiliation
• Kishwaukee Community Hospital

  • General Acute Care Hospital
  • Dekalb, IL
  • NPI 1669534517
  Care Compare affiliation
• Valley West Community Hospital

  • Critical Access Hospital
  • Sandwich, IL
  • NPI 1184705931
  Care Compare affiliation

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1396191359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-766-7334",
            "fax_number": "815-766-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-766-7334",
            "fax_number": "815-766-9768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17100 Swallow Ln",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604678495",
            "country_code": "US",
            "telephone_number": "708-254-0211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGSTROM",
        "first_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-09",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036148007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe Gutierrez, PHARMD
• Pamela A Hadley, PH.D., CCC-SLP
• Katie Haft
• Morgan Haga
• Devonta Haggard
• Cheryl Renee Hahn, CRSS
• Sydney Hall
• Caitlin Halloran
• Jessica Patricia Halper, LSW
• Ian Hamilton, DNP, CRNA

• Emergency Medicine Physician in Dekalb, IL
• Providers in Dekalb, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.