Individual provider Active NPI

Joann Hageman, P.A.

  • Medical Physician Assistant
  • Tulsa, OK
National Provider Identifier
1760454268
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1151 Issued in NE
Practice address
8801 S 101St East Ave
Tulsa, OK 74133-5716
Phone
(918) 294-6911
Fax
(918) 294-4759
NPI assigned
Feb 7, 2006
Last updated
Dec 13, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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 1151 NE Primary

Addresses

Primary practice location

8801 S 101St East Ave
Tulsa, OK 74133-5716

Mailing address

8801 S 101St East Ave
Tulsa, OK 74133-5716
Phone (918) 294-6911

Other identifiers 2

IdentifierTypeStateIssuer
470748011-12MedicaidNE
200093200AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20041012000957 NE Practitioner - Physician Assistant 8325008659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.5 of 100Reported as group
Quality
90.88
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1542OKMDRegistered Dietitian
1151NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
New Century Physicians of Nebraska LLC CurrentSince Jan 1, 2010 Accepting new patients
Omaha Emergency Physicians PC Past Accepting new patients
Southcrest Emergency Physicians PC Past Accepting new patients

Locations

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

11111 S 84th St
Papillion, NE 68046
Phone (402) 593-3000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1760454268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8801 S 101ST EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335716",
            "telephone_number": "918-294-6911",
            "fax_number": "918-294-4759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8801 S 101ST EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335716",
            "telephone_number": "918-294-6911",
            "fax_number": "918-294-4759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEMAN",
        "first_name": "JOANN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470748011-12",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200093200A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.