Individual provider Active NPI

Thomas Hagner, LICSW

  • Clinical Social Worker
  • Cottage Grove, MN
National Provider Identifier
1992802714
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
33619 Issued in MN
Practice address
8611 W Point Douglas Rd S
Cottage Grove, MN 55016-4005
Phone
(651) 458-1884
Fax
(651) 241-0345
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 983 NH
Clinical Social Worker 1041C0700X 33619 MN Primary

Addresses

Primary practice location

8611 W Point Douglas Rd S
Cottage Grove, MN 55016-4005

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Other practice location 1

1228 Elm St
Manchester, NH 03101-1349
Phone (603) 668-4111

Other practice location 2

14A Tsienneto Rd
Derry, NH 03038-1505
Phone (603) 537-1300

Other identifiers 3

IdentifierTypeStateIssuer
020258994-43OtherNHHARVARD PILGRIM
14Y001069NH01OtherNHBLUE CROSS
2035549OtherNHCIGNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address thomashagner@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040313000064 NH Practitioner - Clinical Social Worker 7517856917 Reassigns benefits to 1 organization
I20250529000501 MN Practitioner - Clinical Social Worker 7517856917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

8611 W Point Douglas Rd S
Cottage Grove, MN 55016-4005
Phone (651) 458-1884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
983NHMDMental Health Counselor
33619MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Jul 14, 2025 Accepting new patients
Allina Health System CurrentSince Jul 14, 2025 Accepting new patients
Derry Medical Center, PA CurrentSince Apr 7, 2015 Accepting new patients
Allina Health System Current Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

8611 W Point Douglas Rd S
Cottage Grove, MN 55016
Phone (651) 458-1884

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

6 Tsienneto Rd
Ste 100
Derry, NH 03038
Phone (603) 537-3028

14 Tsienneto Rd
Bldg B
Derry, NH 03038

14A Tsienneto Rd
Derry, NH 03038
Phone (603) 537-1380

50 Michels Way
Unit 102
Londonderry, NH 03053

Interoperability endpoints

  • Direct secure messaging: thomashagner@dmcnh.allscriptsdirect.net
  • Direct secure messaging: thagner732316@excellian.direct.allina.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1992802714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8611 W POINT DOUGLAS RD S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550164005",
            "telephone_number": "651-458-1884",
            "fax_number": "651-241-0345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1228 Elm St",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031011349",
            "country_code": "US",
            "telephone_number": "603-668-4111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14A Tsienneto Rd",
            "address_purpose": "LOCATION",
            "city": "Derry",
            "state": "NH",
            "postal_code": "030381505",
            "country_code": "US",
            "telephone_number": "603-537-1300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGNER",
        "first_name": "THOMAS",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "983",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "33619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "020258994-43",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "14Y001069NH01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2035549",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomashagner@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "8611 W Point Douglas Rd S",
            "city": "Cottage Grove",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550164005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cottage Grove, MN

Sources for this page

Verify at the official NPI Registry.