NPIMap

Individual provider Active NPI

Jedd A Hagen, MD

  • Medical Microbiology Physician
  • Carroll, IA
National Provider Identifier
1831206234
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Microbiology PhysicianTaxonomy code 207ZM0300X
License
30259 Issued in IA
Practice address
311 S Clark St
Carroll, IA 51401-3038
Phone
(712) 792-8257
Fax
(712) 792-8234
NPI assigned
Aug 23, 2006
Last updated
Sep 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Microbiology Physician 207ZM0300X 30259 IA Primary

Addresses

Primary practice location

311 S Clark St
Carroll, IA 51401-3038

Mailing address

311 S Clark St
Carroll, IA 51401-3038
Phone (712) 794-5257

Other identifiers 2

IdentifierTypeStateIssuer
0119636MedicaidIA
50190OtherIABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050428001195 IA Practitioner - Pathology 8527007541 Reassigns benefits to 8 organizations
Practice locations: Carroll, IA

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Sanford School of Medicine of University of South Dakota, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Anthony Regional Hospital and Nursing HomeGroup PAC ID 4688586829, shared by 8 NPIs, 49 clinicians

Practice addresses (Care Compare)

311 S Clark St
Carroll, IA 51401-3038
Phone (712) 792-3581

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.64 of 100Reported as group
Quality
69.74
Promoting interoperability
83
Improvement activities
40
Cost
69.88

Merit-based Incentive Payment System (MIPS)

Final score
92.09 of 100Reported as group
Quality
92.17
Promoting interoperability
88
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30259IAMDMedical Microbiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loring Hospital CurrentSince Jul 1, 2021 Accepting new patients
Loring Hospital CurrentSince Jul 1, 2021 Accepting new patients
Loring Hospital Current Accepting new patients
Pocahontas Community Hospital Current Accepting new patients
Pocahontas Community Hospital CurrentSince Aug 1, 2021 Accepting new patients
St Anthony Regional Hospital and Nursing Home CurrentSince Aug 1, 2021 Accepting new patients
Audubon County Memorial Hospital Current Accepting new patients
St Anthony Regional Hospital and Nursing Home Current Accepting new patients
Audubon County Memorial Hospital CurrentSince Aug 1, 2021 Accepting new patients
St Anthony Regional Hospital and Nursing Home CurrentSince Aug 1, 2021 Accepting new patients

Locations

515 Pacific Ave
Audubon, IA 50025
Phone (712) 563-2611

311 S Clark St
Carroll, IA 51401
Phone (712) 792-3581

606 NW 7th St
Pocahontas, IA 50574
Phone (712) 335-3501

211 Highland Ave
Sac City, IA 50583
Phone (712) 662-7105

Interoperability endpoints

  • Direct secure messaging: jhagen223625@uihcdirect.org

Organizations & group practices 10

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1831206234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S CLARK ST",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013038",
            "telephone_number": "712-794-5257",
            "fax_number": "712-794-5234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S CLARK ST",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013038",
            "telephone_number": "712-792-8257",
            "fax_number": "712-792-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "JEDD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZM0300X",
            "taxonomy_group": "",
            "desc": "Pathology, Medical Microbiology",
            "state": "IA",
            "license": "30259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0119636",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "50190",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carroll, IA

Sources for this page

Verify at the official NPI Registry.