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JACOB PATRICK HAGEN
NPI 1114867694
Student in an Organized Health Care Education/Training Program in Thibodaux, LA

Active since April 01, 2026PECOS Enrolled
607 COUNTRY CLUB BLVD, THIBODAUX, LA 70301(985) 859-9030 Get Directions Write a Review

NPPES record last updated: April 1, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacob Patrick Hagen NPPES

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

JACOB PATRICK HAGEN (NPI 1114867694) is an individual student in an organized health care education/training program in Thibodaux, Louisiana and active in the NPI registry since April 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114867694
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACOB PATRICK HAGEN
Location Address607 COUNTRY CLUB BLVDThibodaux, LA 70301-3713
Mailing Address607 Country Club BlvdThibodaux, LA 70301-3713 · (985) 859-9030
Phone(985) 859-9030
Sole ProprietorNo
Enumeration DateApril 1, 2026
NPPES CertifiedApril 1, 2026
✔ NPI 1114867694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
607 COUNTRY CLUB BLVD, Thibodaux, LA 70301
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Patrick Hagen 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.

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 Jacob Hagen's NPI number?

The NPI number for Jacob Hagen is 1114867694. It was assigned to this individual provider in the NPPES registry on April 1, 2026.

Where is Jacob Hagen located?

Jacob Hagen practices at 607 Country Club Blvd, Thibodaux, LA 70301. The listed phone number is (985) 859-9030.

What is Jacob Hagen's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jacob Hagen enrolled in Medicare?

Yes. Jacob Hagen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Hagen was last updated on April 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.