Active NPI
Michael Hagerty, M.A. SLP
- Speech-Language Pathologist
- Milwaukee, WI
National Provider Identifier
1568911857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4316-154
- Practice address
- 3200 S 20TH St
Milwaukee, WI 53215-4442 - Phone
- (414) 389-3274
- NPI assigned
- Sep 27, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4316-154 | WI | Primary |
Addresses
Primary practice location
3200 S 20TH St
Milwaukee, WI 53215-4442
Mailing address
1219 N 62ND St Apt 207
Wauwatosa, WI 53213-3075
Phone (414) 559-0203
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4316-154 | WI | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabcare Group East, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474934400000",
"number": "1568911857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1219 N 62ND ST APT 207",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532133075",
"telephone_number": "414-559-0203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 S 20TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532154442",
"telephone_number": "414-389-3274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGERTY",
"first_name": "MICHAEL",
"credential": "M.A. SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-27",
"last_updated": "2016-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "4316-154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.