Individual provider Active NPI

Patrick James O'Hagan, PA-C

  • Medical Physician Assistant
  • Traverse City, MI
National Provider Identifier
1679114847
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
4100 Park Forest Dr
Traverse City, MI 49684
Phone
(231) 935-5710
Fax
(231) 935-6081
NPI assigned
Sep 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

4100 Park Forest Dr
Traverse City, MI 49684

Mailing address

1105 Sixth St
Traverse City, MI 49684-2386
Phone (231) 935-5710

Other practice location 1

1535 Gull Rd Ste 105
Kalamazoo, MI 49048-1630
Phone (269) 385-9900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KGH-DHC@direct.kalamazoogastro.nextgenshare.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191206002392 MI Practitioner - Physician Assistant 9234562141 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

1121 6TH St
Suite 316
Traverse City, MI 49684-2345
Phone (231) 392-8280

1400 Medical Campus Dr
Traverse City, MI 49684-7823
Phone (231) 935-8000

4100 Park Forest Dr
Suite 208
Traverse City, MI 49684-7306
Phone (231) 935-5710

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Promed CurrentSince Jan 1, 2022 Accepting new patients
Munson Medical Center CurrentSince Sep 16, 2024 Accepting new patients
Promed Healthcare CurrentSince Jan 1, 2022 Accepting new patients
Munson Medical Center CurrentSince Sep 16, 2024 Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

3770 Capital Ave SW
Ste C
Battle Creek, MI 49015
Phone (269) 441-1755

1535 Gull Rd
Ste 105
Kalamazoo, MI 49048
Phone (616) 381-1433

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

4100 Park Forest Dr
Traverse City, MI 49684
Phone (231) 392-8900

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

4100 Park Forest Dr
Ste 208
Traverse City, MI 49684
Phone (231) 392-8705

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1679114847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842386",
            "telephone_number": "231-935-5710",
            "fax_number": "231-935-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-935-5710",
            "fax_number": "231-935-6081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1535 Gull Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490481630",
            "country_code": "US",
            "telephone_number": "269-385-9900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'HAGAN",
        "first_name": "PATRICK",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-30",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KGH-DHC@direct.kalamazoogastro.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1535 Gull Rd Ste 105",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490481630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.