NPIMap

Individual provider Active NPI

Ryan T Hagino, MD

  • Vascular Surgery Physician
  • Duluth, MN
National Provider Identifier
1891802955
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
44704 Issued in MN
Practice address
400 East 3Rd Street
Duluth, MN 55805
Phone
(218) 786-8318
NPI assigned
Aug 24, 2006
Last updated
May 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 44704 MN Primary

Addresses

Primary practice location

400 East 3Rd Street
Duluth, MN 55805

Mailing address

400 East 3Rd Street
Duluth, MN 55805
Phone (218) 786-8318

Other identifiers 1

IdentifierTypeStateIssuer
1891802955MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20140807001512 HI Practitioner - Vascular SurgeryPractitioner - General Surgery 8628061173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Northwestern University Feinberg Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

82 Puuhonu PL
Suite 100
Hilo, HI 96720-2010
Phone (808) 969-9669

888 S King St
Honolulu, HI 96813-3097
Phone (808) 522-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as group
Quality
67.55
Promoting interoperability
100
Improvement activities
40
Cost
78.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal15
Leg revascularization (restoring blood flow)27
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44704MNMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Jul 7, 2014 Accepting new patients
Straub Clinic & Hospital CurrentSince Jul 7, 2014 Accepting new patients
The University of Texas Health Science Center at San Antonio Past Accepting new patients
Straub Clinic & Hospital Past Accepting new patients

Locations

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

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.

Hospital & facility affiliations 5

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304899200000",
    "number": "1891802955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EAST 3RD STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 EAST 3RD STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGINO",
        "first_name": "RYAN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2011-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MN",
            "license": "44704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891802955",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.