Individual provider Active NPI

Bryan M Hagen, DNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bend, OR
National Provider Identifier
1790872000
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201250173NP Issued in OR
Practice address
908 NE 4TH St Ste 100
Bend, OR 97701-4646
Phone
(541) 617-7365
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201250173NP OR Primary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 201042999RN OR

Addresses

Primary practice location

908 NE 4TH St Ste 100
Bend, OR 97701-4646

Mailing address

685 SE 3Rd St
Bend, OR 97702-1754
Phone (541) 617-7365

Other identifiers 1

IdentifierTypeStateIssuer
500689745MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20130528000684 OR Practitioner - Nurse Practitioner 4981842291 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hagen Psychiatry LLC Psychiatric/Mental Health Current Accepting new patients
Lifeworks NW CurrentSince Feb 11, 2013 Accepting new patients

Locations

2955 N Highway 97
Ste 100
Bend, OR 97703
Phone (541) 419-6958

971 SW Walnut St
Hillsboro, OR 97123
Phone (503) 640-5297

5415 SW Westgate Dr
Portland, OR 97221
Phone (503) 645-9010

Interoperability endpoints

  • Direct secure messaging: bhagen680812@direct.ochin.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1790872000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 SE 3RD ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021754",
            "telephone_number": "541-617-7365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 NE 4TH ST STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014646",
            "telephone_number": "541-617-7365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "BRYAN",
        "middle_name": "M",
        "credential": "DNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201250173NP",
            "primary": true
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "OR",
            "license": "201042999RN",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500689745",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.