Larry David Hagaman, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA0003049 Issued in FL

Practice address

721 W Robertson St
Ste 102
Brandon, FL 33511-4934

Phone

(813) 684-3707

Fax

(813) 643-2457

NPI assigned

Jun 27, 2008

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Musculoskeletal Institute Chartered

  • Orthopaedic Surgery Physician
  • Largo, FL
  • NPI 1518590314
  NPD
• Tallahassee Orthopedic Clinic III PL

  • Medical Specialty Clinic/Center
  • Tallahassee, FL
  • NPI 1194778050
  NPD
• Tallahassee Orthopedic Clinic III, P.L.

  • Durable Medical Equipment & Medical Supplies
  • Panama City Beach, FL
  • NPI 1497617948
  NPD
• Okun and Maddalon M.D. PA

  • Specialist
  • Brandon, FL
  • NPI 1407891302
  NPD (past)

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1578725834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 W ROBERTSON ST",
            "address_2": "STE 102",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114934",
            "telephone_number": "813-684-3707",
            "fax_number": "813-647-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W ROBERTSON ST",
            "address_2": "STE 102",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114934",
            "telephone_number": "813-684-3707",
            "fax_number": "813-643-2457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAMAN",
        "first_name": "LARRY",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA0003049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Gwaltney
• H-Bay Ministries, Inc.
• My My Ha, MA, BCBA
• Nancy Hadsock, M.S., C.C.C.
• Shadan Hafsa
• Mathew Adam Hagen
• Jessica Hager
• Jennifer Haglund, COTA
• Nafeeza Hakeem-Hosein
• Andre Halabu, MD

• Medical Physician Assistant in Brandon, FL
• Providers in Brandon, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.