Mark D Hagedorn, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

20000 Issued in CT

Practice address

240 East St
Plainville, CT 06062

Phone

(860) 747-4541

Fax

(860) 793-1218

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Locations

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  CT

  Medicare reassignment NPD
• Hagedorn Assoc PC

  • Urgent Care Clinic/Center
  • Plainville, CT
  • NPI 1114059466
  NPD (past)
• Occupational Medicine of the Northeast, LLC

  • Urgent Care Clinic/Center
  • Plainville, CT
  • NPI 1699099630
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972617827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 EAST ST",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "06062",
            "telephone_number": "860-747-4541",
            "fax_number": "860-793-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 EAST ST",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "06062",
            "telephone_number": "860-747-4541",
            "fax_number": "860-793-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEDORN",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "20000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jocelyn Guerraz
• Krishna S Gunturu, MBBS
• GV Health Practice, LLC
• Karen T Haberski
• Hagedorn Assoc PC
• Rebecca Beth Halbert, MSW
• Scott David Hale, B.S.
• Briana Rose Hall
• Donna Hammersley
• Hannas Healing Hounds and Hooves LLC

• Emergency Medicine Physician in Plainville, CT
• Providers in Plainville, CT by specialty
• Emergency Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.