Individual provider Active NPI

Martha Hagenbrock, N.P.

  • Nurse Practitioner
  • Rochester, MN
National Provider Identifier
1679705107
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4670 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905
Phone
(507) 284-2511
NPI assigned
Aug 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NPF19022 CA
Adult Health Nurse Practitioner 363LA2200X 608593 CA
Nurse Practitioner 363L00000X 4670 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other names 1

  • Martha C Hartwich Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mhagenbrock134579@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20160817001311 MN Practitioner - Nurse Practitioner 8123284775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19022CAMDProfessional Counselor
NPF19022CAMDNurse Practitioner
4670MNMDNurse Practitioner
608593CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Current Accepting new patients
Mayo Clinic CurrentSince Aug 15, 2016 Accepting new patients
Mayo Clinic CurrentSince Aug 15, 2016 Accepting new patients
Mayo Clinic Past Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: mhagenbrock134579@ehrdirect.mayoclinicmsg.org

Organizations & group practices 5

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 1

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": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1679705107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55905",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGENBROCK",
        "first_name": "MARTHA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-17",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NPF19022",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "608593",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "4670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhagenbrock134579@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "HARTWICH",
            "middle_name": "C",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.