NICOLE ALEXANDRA HAGEN
NPI 1093503583
Physician Assistant in Fort Wayne, IN

Q: What is Nicole Hagen's NPI number?

The NPI number for Nicole Hagen is 1093503583. It was assigned to this individual provider in the NPPES registry on April 25, 2025.

Q: What is Nicole Hagen's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Hagen was last updated on October 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 25, 2025PECOS EnrolledAccepts Medicare Assignment

11104 PARKVIEW CIRCLE DR STE 110, FORT WAYNE, IN 46845(260) 425-6780(260) 425-6615 Get Directions Write a Review

NPPES record last updated: October 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Nicole Alexandra Hagen NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE ALEXANDRA HAGEN (NPI 1093503583) is an individual physician assistant in Fort Wayne, Indiana, licensed in Indiana (10004914A) and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS, is affiliated with Parkview Regional Medical Center, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1093503583

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameNICOLE ALEXANDRA HAGEN

Location Address11104 PARKVIEW CIRCLE DR STE 110Fort Wayne, IN 46845-1673

Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701

Phone(260) 425-6780

Fax(260) 425-6615

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateApril 25, 2025

Last NPPES UpdateOctober 2, 2025

NPPES CertifiedOctober 2, 2025

✔ NPI 1093503583 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in IN · 10004914A

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

11104 PARKVIEW CIRCLE DR STE 110, Fort Wayne, IN 46845

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicole Alexandra Hagen is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729588876

PECOS Enrollment IDI20250822002341

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Parkview Regional Medical Center

Acute Care Hospitals · Fort Wayne, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150021

Location11109 Parkview Plaza DriveFort Wayne, IN 46845 · Allen County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46845 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KELLEY RAE LOCKHART M.D.

Internal Medicine (Critical Care Medicine)