Individual provider Active NPI

Vincent T Hagedorn, PA

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1568602001
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06072 Issued in TX
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

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
210775704MedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090326000081 TX Practitioner - Physician Assistant 0547327124 Reassigns benefits to 10 organizations

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
American Current Care PAGroup PAC ID 9739260019, 545 clinicians
Usacs Integrated Acute Care Services of Texas, PLLCGroup PAC ID 7618237264, 398 clinicians

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 Hospital, Austin, TX, CCN 450056
  • Ascension Seton Southwest Hospital, Austin, TX, CCN 450865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA06072TXMDPhysician Assistant
TEMPLICENSETXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Critical Care Specialists PA CurrentSince Dec 1, 2014 Accepting new patients
Vpa of Texas PLLC CurrentSince Feb 5, 2021 Accepting new patients
American Current Care P.a. CurrentSince Jul 26, 2023 Accepting new patients
American Current Care, P.a. CurrentSince Jul 26, 2023 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

  • FHIR API: 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.

View all 13

Hospital & facility affiliations 2

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": "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

Verify at the official NPI Registry.