Individual provider Active NPI

Scott W Hagen, NP-C

  • Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1679752315
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
17030 Issued in CA
Practice address
7014 N Whitney Ave
Fresno, CA 93720-0155
Phone
(559) 321-2858
Fax
(559) 321-2780
NPI assigned
Oct 30, 2007
Last updated
Sep 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 17030 CA Primary

Addresses

Primary practice location

7014 N Whitney Ave
Fresno, CA 93720-0155

Mailing address

7014 N Whitney Ave
Fresno, CA 93720-0155
Phone (559) 321-2858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20090824000542 CA Practitioner - Nurse Practitioner 2466506332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Todos Para la SaludGroup PAC ID 1951673748, 9 clinicians

Practice addresses (Care Compare)

3830 N 1St St
Fresno, CA 93726-2328

4420 N 1St St
Suite 123
Fresno, CA 93726-2328
Phone (559) 231-5366

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17030CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Todos Para la Salud CurrentSince Jun 18, 2024 Accepting new patients
Todos Para la Salud CurrentSince Jun 18, 2024 Accepting new patients

Locations

4420 N 1st St
Ste 123
Fresno, CA 93726
Phone (559) 231-5366

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCGBCD

Organizations & group practices 2

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": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1679752315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7014 N WHITNEY AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937200155",
            "telephone_number": "559-321-2858",
            "fax_number": "559-321-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7014 N WHITNEY AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937200155",
            "telephone_number": "559-321-2858",
            "fax_number": "559-321-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "SCOTT",
        "middle_name": "W",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-30",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "17030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.