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ANALISE ELISABETH HAGSTROM NP
NPI 1104296409
Nurse Practitioner in Mill Valley, CA

Active since September 29, 2015PECOS Enrolled
591 REDWOOD HWY FRONTAGE RD STE 5215, MILL VALLEY, CA 94941(415) 381-5400 Get Directions Write a Review

NPPES record last updated: October 22, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 11, 2025, Nov 13, 2024, Nov 8, 2024 and 1 more (4 updates tracked since 2015).

About Analise Elisabeth Hagstrom Np NPPES

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

ANALISE ELISABETH HAGSTROM NP (NPI 1104296409) is an individual nurse practitioner in Mill Valley, California, licensed in California (95003570) and active in the NPI registry since September 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104296409
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameANALISE ELISABETH HAGSTROMCredential: NP
Location Address591 REDWOOD HWY FRONTAGE RD STE 5215Mill Valley, CA 94941-3016
Mailing Address101 H St Ste GPetaluma, CA 94952-5100 · (773) 344-2864 · Fax (415) 907-9183
Phone(415) 381-5400
Sole ProprietorNo
Enumeration DateSeptember 29, 2015
Last NPPES UpdateOctober 22, 20254 updates tracked since enumeration
NPPES CertifiedOctober 22, 2025
✔ NPI 1104296409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CA · 95003570
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X · License 209012443 (IL)
591 REDWOOD HWY FRONTAGE RD STE 5215, Mill Valley, CA 94941
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Analise Elisabeth Hagstrom Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Analise Hagstrom reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ucsf Health Medical Foundation
13 mi
Pediatrics
6425 CHRISTIE AVE STE 220
Emeryville, CA 94608
  • Reassigned Medicare billing, California enrollment
  • 79 clinicians in this Medicare group
NPI 1043628316 (415) 476-7220
Sutter Bay Medical Foundation
19 mi
Multi-Specialty
12 CAMINO ENCINAS
Orinda, CA 94563
  • Reassigned Medicare billing, California enrollment
  • 4,479 clinicians in this Medicare group
NPI 1366898538 (510) 204-8180

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94941 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
$104.67 typical visit price
range $69.07 – $202.63
Typical copayment $26.16 (range $17.26 – $50.65)
Most-billed visit code 99203
Established Patient
$119.61 typical visit price
range $23.44 – $166.64
Typical copayment $29.90 (range $5.86 – $41.66)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Analise Hagstrom's NPI number?

The NPI number for Analise Hagstrom is 1104296409. It was assigned to this individual provider in the NPPES registry on September 29, 2015.

Where is Analise Hagstrom located?

Analise Hagstrom practices at 591 Redwood Hwy Frontage Rd Ste 5215, Mill Valley, CA 94941. The listed phone number is (415) 381-5400.

What is Analise Hagstrom's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Analise Hagstrom enrolled in Medicare?

Yes. Analise Hagstrom is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Analise Hagstrom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Analise Hagstrom reassigns Medicare benefits to 2 organizations: Ucsf Health Medical Foundation (Emeryville, CA) and Sutter Bay Medical Foundation (Orinda, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Analise Hagstrom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Analise Hagstrom was last updated on October 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.