Robert D Hagberg, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5438 Issued in AK

Practice address

Mat Su Empercency Medicine Physicians at Msrmc
2500 S. Woodworth Loop
Palmer, AK 99645

Phone

(907) 746-7511

Fax

(907) 746-7533

NPI assigned

Jan 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Mat-Su Emergency Medicine Physicians Corp

  • Emergency Medicine Physician
  • Palmer, AK
  • NPI 1073548129
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760532006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 874388",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996874388",
            "telephone_number": "907-376-9893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MAT SU EMPERCENCY MEDICINE PHYSICIANS AT MSRMC",
            "address_2": "2500 S. WOODWORTH LOOP",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "99645",
            "telephone_number": "907-746-7511",
            "fax_number": "907-746-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGBERG",
        "first_name": "ROBERT",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AK",
            "license": "5438",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8938154",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "38154",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maggie Gruber
• Erica Guice
• Shannon Gulley, M.D.
• Hope Haag
• Kristine D Haddock
• Melissa Hall
• Mike J Hall
• Theresa Gale Hall, APRN
• Yvonne E Hall, L.P.N. L.M.T. P.H.D
• Ellen J Halverson, M.D.

• Emergency Medicine Physician in Palmer, AK
• Providers in Palmer, AK by specialty
• Emergency Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.