NPIMap

Individual provider Active NPI

Jennifer A Hagen, CRNA

  • Certified Registered Nurse Anesthetist
  • Watseka, IL
National Provider Identifier
1881819639
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209-003217 Issued in IL
Practice address
200 E Fairman Ave
Watseka, IL 60970-1644
Phone
(815) 432-5041
Fax
(815) 432-7821
NPI assigned
Apr 16, 2007
Last updated
Jun 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209-003217 IL Primary

Addresses

Primary practice location

200 E Fairman Ave
Watseka, IL 60970-1644

Mailing address

2141 E Blackberry CT
Watseka, IL 60970-7512
Phone (815) 432-7778

Other practice location 1

1000 Health Center Dr
Mattoon, IL 61938-4644
Phone (217) 258-2440

Other identifiers 1

IdentifierTypeStateIssuer
041-264487OtherILLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120322000452 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587824933 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians
Vigilance Anesthesiologists and Pain Specialists PCGroup PAC ID 4284975541, 6 clinicians

Practice addresses (Care Compare)

1000 Health Ctr Dr
Mattoon, IL 61938-4644
Phone (217) 258-2525

1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-4251

200 E Fairman Ave
Watseka, IL 60970-1644
Phone (815) 432-5841

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209-003217ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association Current Accepting new patients
Gibson Community Hospital Association CurrentSince Feb 1, 2021 Accepting new patients
Pinckneyville Community Hospital CurrentSince Jun 6, 2025 Accepting new patients
Iroquois Memorial Hospital and Resident Home Current Accepting new patients
Sarah Bush Lincoln Health Center Current Accepting new patients
Pinckneyville Community Hospital CurrentSince Jun 6, 2025 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Nov 1, 2018 Accepting new patients
Gibson Community Hospital Association CurrentSince Feb 1, 2021 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Apr 15, 2022 Accepting new patients
Christie Clinic, PLLC PastSince May 15, 2001 Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255

77 N Airlite St
Elgin, IL 60123
Phone (847) 622-3407

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

7 Doctors Park
Gibson City, IL 60936
Phone (217) 784-5500

333 Madison St
Joliet, IL 60435
Phone (815) 725-7222

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200

5383 State Route 154
Pinckneyville, IL 62274
Phone (618) 357-2131

1400 W Park St
Urbana, IL 61801
Phone (217) 337-2000

602 W University Ave
Urbana, IL 61801
Phone (217) 383-3141

200 E Fairman Ave
Watseka, IL 60970
Phone (815) 432-5201

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

Organizations & group practices 12

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 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1881819639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 E BLACKBERRY CT",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609707512",
            "telephone_number": "815-432-7778",
            "fax_number": "815-432-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E FAIRMAN AVE",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701644",
            "telephone_number": "815-432-5041",
            "fax_number": "815-432-7821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Health Center Dr",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619384644",
            "country_code": "US",
            "telephone_number": "217-258-2440",
            "fax_number": "217-258-2186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209-003217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "041-264487",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watseka, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.