Lisa Cynthia Hage, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME116550 Issued in FL

Practice address

12196 County Road 512
Fellsmere, FL 32948-5463

Phone

(772) 257-8224

Fax

(772) 252-3245

NPI assigned

Nov 7, 2012

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 1

Medicare fee-for-service enrollment

Enrolled in FL

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

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 and National Provider Directory roles.

• Treasure Coast Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Fellsmere, FL
  • NPI 1891740916
  NPD (past)

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1891049284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 INDIAN RIVER BLVD STE B210",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607113",
            "telephone_number": "772-257-8224",
            "fax_number": "772-252-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12196 COUNTY ROAD 512",
            "city": "FELLSMERE",
            "state": "FL",
            "postal_code": "329485463",
            "telephone_number": "772-257-8224",
            "fax_number": "772-252-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGE",
        "first_name": "LISA",
        "middle_name": "CYNTHIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-07",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME116550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME116550",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vivienne M Clarke, MD
• Pamela J Corkum, LICSW
• Dawn M Fassett
• Michael P Ferrentino, ED.D., L.M.H.C.
• Jane E Guiles, LCSW
• Daniel B Hammond, MD
• Linda R Hart, RNFA
• Sara Justine Henney, O.D.
• Marlene Jean, APRN
• Matoga Jones

• Pediatrics Physician in Fellsmere, FL
• Providers in Fellsmere, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.