Alan Kyle Hagstrom, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME114651 Issued in FL

Practice address

1415 Panther LN
Naples, FL 34109-7874

Phone

(239) 404-3379

NPI assigned

Jan 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VT

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

Specialty

PsychiatryAlso: Anesthesiology, Pain Management

Education

Geisel School of Medicine at Dartmouth, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brattleboro RetreatGroup PAC ID 7012828908, 61 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brattleboro Memorial Hospital Hospital, Brattleboro, VT, CCN 470011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Brattleboro Retreat

  • Psychiatric Hospital
  • Brattleboro, VT
  • NPI 1730185232
  Medicare reassignment Care Compare group NPD
• Brattleboro Retreat

  dba Retreat Healthcare

  • Institutional Pharmacy
  • Brattleboro, VT
  • NPI 1295947950
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brattleboro Memorial Hospital

  • General Acute Care Hospital
  • Brattleboro, VT
  • NPI 1306849708
  Care Compare affiliation

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1619947801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PARK SHORE DR APT 202",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033440",
            "telephone_number": "239-404-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 PANTHER LN",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341097874",
            "telephone_number": "239-404-3379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1845 Veterans Park Dr",
            "address_2": "Ste 101",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341090493",
            "country_code": "US",
            "telephone_number": "239-254-0986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGSTROM",
        "first_name": "ALAN",
        "middle_name": "KYLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "23903",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME114651",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME114651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "436601",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James A Hadley, MD
• Naiel Hafez, MD
• Meagan Hafkemeyer, DC
• James S Hagerman, D.C.
• Megan Haggard, APRN
• Mark Anthony Hahn, MSW
• Nancy Hahn, A.R.N.P.
• Valerie Jean Hahn, ARNP
• Andrew Haidet
• Tadelech Hailu

• Psychiatry Physician in Naples, FL
• Providers in Naples, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.

Verify at the official NPI Registry.