Individual provider Active NPI

Paul W Hagan, M.D.

  • Anesthesiology Physician
  • Petoskey, MI
National Provider Identifier
1578798203
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301105022 Issued in MI
Practice address
416 Connable Ave
Petoskey, MI 49770-2212
Phone
(231) 348-2795
Fax
(231) 348-2031
NPI assigned
May 26, 2009
Last updated
Jun 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301105022 MI Primary
Surgery Physician 208600000X MT195336 PA

Addresses

Primary practice location

416 Connable Ave
Petoskey, MI 49770-2212

Mailing address

602 Jackson Street
Petoskey, MI 49770
Phone (231) 348-2795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20140729001795 MI Practitioner - Anesthesiology 2668604356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Wayne State University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Anesthesia Providers PCGroup PAC ID 4789579863, 31 clinicians

Practice addresses (Care Compare)

416 Connable Ave
Petoskey, MI 49770-2212
Phone (231) 487-4000

748 S Main St
McLaren Northern Michigan Cheboygan
Cheboygan, MI 49721-2220
Phone (231) 627-4364

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.53 of 100Reported as group
Quality
90
Improvement activities
20
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301105022MIMDAnesthesiology Physician
MT195336PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Anesthesia Providers PC Anesthesiology CurrentSince Jul 14, 2014 Accepting new patients

Locations

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

602 Jackson St
Petoskey, MI 49770
Phone (231) 348-2795

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1578798203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 JACKSON STREET",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "231-348-2795",
            "fax_number": "231-348-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 CONNABLE AVE",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702212",
            "telephone_number": "231-348-2795",
            "fax_number": "231-348-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "PAUL",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-26",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301105022",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT195336",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.