Patricia Ivonne Hago, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

40944 Issued in WI

Practice address

801 S 70TH St
West Allis, WI 53214-3147

Phone

(414) 773-6600

Fax

(414) 773-6656

NPI assigned

Jun 21, 2005

Last updated

Jun 11, 2012By the provider in NPPES

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

Other identifiers 4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sixteenth Street Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1316587439

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1770589202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "address_2": "ATTN: CSMCP CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-773-6600",
            "fax_number": "414-773-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S 70TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532143147",
            "telephone_number": "414-773-6600",
            "fax_number": "414-773-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGO",
        "first_name": "PATRICIA",
        "middle_name": "IVONNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "40944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32606100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7590215",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATEHEALTHCARE SYSTEM",
            "identifier": "810127302",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7310019",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Gruner, RN CNM
• Guardian Pharmacy of Madison, LLC (Guardian Pharmacy of Wisconsin)
• Guy Enterprises, LLC (Pro Providers Personal Care Agency)
• Sieanna Mae Haakenson
• Sarah Elizabeth Haapakoski, APNP
• Madison Jenean Hales
• Michele Hall, MD
• Sara Nicole Hall, MD
• Yocheved Yvette Halpern, M.S.
• Bruce P Hamilton, DDS

• Family Medicine Physician in West Allis, WI
• Providers in West Allis, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.