Lauren Hagen, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9115599 Issued in FL

Practice address

3089 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-3216

Phone

(850) 203-3790

NPI assigned

Jan 30, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Dermatology Group PAGroup PAC ID 9931277233, 45 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Southeastern Dermatology Group PA

  • Dermatology Physician
  • Panama City, FL
  • NPI 1518972231
  Medicare reassignment Care Compare group
• Vascular Associates LLC

  • Specialist
  • Panama City, FL
  • NPI 1821129313
  NPD (past)

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

{
    "created_epoch": "1643500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1699428771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2053 FOUNTAIN PROFESSIONAL CT STE B",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325665109",
            "telephone_number": "850-530-0225",
            "fax_number": "850-522-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3089 GULF BREEZE PKWY",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325633216",
            "telephone_number": "850-203-3790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2053 Fountain Professional Ct Ste B",
            "address_purpose": "LOCATION",
            "city": "Navarre",
            "state": "FL",
            "postal_code": "325665109",
            "country_code": "US",
            "telephone_number": "850-601-5905",
            "fax_number": "850-522-8354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "LAUREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-30",
        "last_updated": "2022-06-07",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9115599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gulfside Counseling and Wellness
• Stephen A Gulsby, RPT
• Joshua Gilman Hackel, MD
• Katherine Laguens Haddock, ATC/L, OTC
• Tara Elizabeth Hagan
• Halcyon Rehabilitation, LLC
• Lynette Hale
• Alyssa Hall
• Spring Hall, PTA
• Anna Hardy, LMHC

• Medical Physician Assistant in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.