Individual provider Active NPI

Sara Marie Hagan, MD

  • Pediatrics Physician
  • Oklahoma City, OK
National Provider Identifier
1841857588
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34832 Issued in OK
Practice address
1200 Childrens Ave # 14000
Oklahoma City, OK 73104-4637
Phone
(405) 271-4417
NPI assigned
May 28, 2019
Last updated
Dec 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X 34832 OK Primary

Addresses

Primary practice location

1200 Childrens Ave # 14000
Oklahoma City, OK 73104-4637

Mailing address

1200 Childrens Ave # 14000
Oklahoma City, OK 73104-4637
Phone (405) 271-4417

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221121000421 OK Practitioner - Pediatric Medicine 2466820600 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34832OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Jul 8, 2022 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 8, 2022 Accepting new patients
Summit Medical Center Past Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

1200 Childrens Ave
#14000
Oklahoma City, OK 73104
Phone 4052714417 ext. 42625

34 SW 89th St
Oklahoma City, OK 73139
Phone (405) 488-0750

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Interoperability endpoints

  • Direct secure messaging: shagan24799@ouhealth.direct-ci.net

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": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1841857588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CHILDRENS AVE # 14000",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044637",
            "telephone_number": "405-271-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CHILDRENS AVE # 14000",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044637",
            "telephone_number": "405-271-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "SARA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "34832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.