NPIMap

Individual provider Active NPI

Katie Hagerstrom, MSN, APNP, AGPC-BC

  • Geriatric Medicine (Internal Medicine) Physician
  • Kaukauna, WI
National Provider Identifier
1972994093
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
16206-33 Issued in WI
Practice address
1746 Paul Dr
Kaukauna, WI 54130-3014
Phone
(920) 422-7402
Fax
(920) 543-5288
NPI assigned
Feb 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 16206-33 WI Primary

Addresses

Primary practice location

1746 Paul Dr
Kaukauna, WI 54130-3014

Mailing address

253 Patricia LN
Wrightstown, WI 54180-1201
Phone (920) 512-6489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20250224000369 WI Practitioner - Nurse Practitioner 5698295525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sequoia Integrative Medical Services LLCGroup PAC ID 8527480250, 15 clinicians

Practice addresses (Care Compare)

1351 Ontario Rd
Green Bay, WI 54311-8302
Phone (920) 328-1220

N1916 Greenville Dr
Greenville, WI 54942-8407
Phone (920) 882-5045

Hospital & facility affiliations

  • Ascension at Home Home health agency, Neenah, WI, CCN 527009
  • PRN Home Health and Therapy, LLC Home health agency, Appleton, WI, CCN 527328
  • Commonheart Home Health Home health agency, Waukesha, WI, CCN 527151
  • Unity Hospice Hospice, De Pere, WI, CCN 521503
  • Thedacare Medical Center - Wild Rose Hospital, Wild Rose, WI, CCN 521303
  • Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
16206-33WIMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sequoia Integrative Medical Services LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

1351 Ontario Rd
Green Bay, WI 54311
Phone (920) 328-1220

Organizations & group practices 1

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.

Hospital & facility affiliations 12

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": "1423612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1972994093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 PATRICIA LN",
            "city": "WRIGHTSTOWN",
            "state": "WI",
            "postal_code": "541801201",
            "telephone_number": "920-512-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1746 PAUL DR",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541303014",
            "telephone_number": "920-422-7402",
            "fax_number": "920-543-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGERSTROM",
        "first_name": "KATIE",
        "credential": "MSN, APNP, AGPC-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-11",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WI",
            "license": "16206-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaukauna, WI

Sources for this page

Verify at the official NPI Registry.