Active NPI
Vincent T Hagedorn, PA
- Physician Assistant
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA06072
- Practice address
- 8220 Walnut Hill LN
Suite 408
Dallas, TX 75231-4427 - Phone
- (214) 361-9777
- Fax
- (214) 891-0084
- NPI assigned
- Feb 24, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | TEMPLICENSE | TX | |
| Physician Assistant | 363A00000X | PA06072 | TX | Primary |
Addresses
Primary practice location
8220 Walnut Hill LN
Suite 408
Dallas, TX 75231-4427
Mailing address
8220 Walnut Hill LN
Suite 408
Dallas, TX 75231-4427
Phone (214) 361-9777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 210775704 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10001 S Ih 35 Frontage Rd
300 Suite 300
Austin, TX 78747-1702
Phone (512) 440-0555
1201 W 38TH St
Austin, TX 78705-1006
Phone (512) 324-1000
2000 W Anderson LN
Austin, TX 78757-1220
Phone (512) 459-4367
260 Cully Dr
Kerrville, TX 78028-5950
Phone (830) 258-7747
3801 S Lamar Blvd
Austin, TX 78704-7943
Phone (512) 447-9661
7900 FM
Suite 1826
Austin, TX 78737-1407
Phone (512) 324-9000
800 E Hwy 71
Smithville, TX 78957-1730
Phone (512) 237-3214
Hospital & facility affiliations
- Ascension Seton Medical Center Austin
- Ascension Seton Southwest
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA06072 | TX | MD | Physician Assistant |
| TEMPLICENSE | TX | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Austin Critical Care Specialists PA | Current | Accepting new patients | |
| Vpa of Texas PLLC | Current | Accepting new patients | |
| American Current Care P.a. | Current | Accepting new patients | |
| American Current Care, P.a. | Current | Accepting new patients | |
| Southwest Pulmonary Associates | Past | Accepting new patients |
Locations
15810 Midway Rd
Addison, TX 75001
Phone (972) 458-8111
11113 Research Blvd
Austin, TX 78759
Phone (512) 324-1125
4025 Spid Dr
Corpus Christi, TX 78411
Phone (361) 852-8255
1002 Abc Ave
Ste 600
Freeport, TX 77541
Phone (979) 233-6571
12345 Katy Fwy
Houston, TX 77079
Phone (281) 679-5600
4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511
850 W Central Texas Expy
Killeen, TX 76548
Phone (254) 690-0900
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 13
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.
-
- Health Service Clinic/Center
- Addison, TX
- NPI 1275651002
-
- Internal Medicine Physician
- Cedar Park, TX
- NPI 1801300322
-
- Critical Care Medicine (Internal Medicine) Physician
- Austin, TX
- NPI 1447435805
-
- Emergency Medicine Physician
- Austin, TX
- NPI 1649669672
-
- General Practice Physician
- Dallas, TX
- NPI 1750845863
-
- Emergency Medicine Physician
- Austin, TX
- NPI 1962440933
-
- Critical Care Medicine (Internal Medicine) Physician
- Cedar Park, TX
- NPI 1023522554
-
- Emergency Medicine Physician
- Round Rock, TX
- NPI 1134606353
-
- Emergency Medicine Physician
- Gonzales, TX
- NPI 1164770996
-
- Family Medicine Physician
- Irving, TX
- NPI 1679510499
-
- Urgent Care Clinic/Center
- Beaumont, TX
- NPI 1376356568
-
- Family Medicine Physician
- Irving, TX
- NPI 1942829155
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Austin, TX
- NPI 1164526786
-
- General Acute Care Hospital
- Austin, TX
- NPI 1750499273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696377600000",
"number": "1568602001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8220 WALNUT HILL LN",
"address_2": "SUITE 408",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314427",
"telephone_number": "214-361-9777",
"fax_number": "214-891-0084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8220 WALNUT HILL LN",
"address_2": "SUITE 408",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314427",
"telephone_number": "214-361-9777",
"fax_number": "214-891-0084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGEDORN",
"first_name": "VINCENT",
"middle_name": "T",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-24",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "TEMPLICENSE",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA06072",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "210775704",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.