KENTON LEE HAGAN – Orthopaedic Surgery Physician, NPI 1235524653

KENTON LEE HAGAN is a healthcare provider. based in Fayetteville, Arkansas. specializing in PHYSICAL MEDICINE AND REHABILITATION. They hold a License No. E-12883 (AR). The NPI Number for KENTON LEE HAGAN is 1235524653

Main info

Male
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
KENTON LEE HAGAN
NPI
1235524653
Phone
(479) 966-4187
Address
3900 N PARKVIEW DR
Enumeration Date
2 April 2015
Last Update Date
15 September 2020

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
4799664187
Graduation Year
2015 (11 years ago)
PAC ID
6305143595
Group Practice PAC ID
0042248445
Professional Enrollment ID
I20200506001804
Address ID
AR727036398FA3900XDRXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

86 PHYSICAL MEDICINE AND REHABILITATION in AR

Provider Addresses for KENTON LEE HAGAN

  • 3900 N PARKVIEW DR

    FAYETTEVILLE, AR 727036398

    Phone: (479) 966-4187

    Fax: (479) 966-4197

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-05-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200506001804IPhysical Medicine And RehabilitationARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
Q9967Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml17,49049$0
J1100Injection, dexamethasone sodium phosphate, 1 mg76240$0
Q9966Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml45313$0
99213Established patient office or other outpatient visit, 20-29 minutes380241$0
J1040Injection, methylprednisolone acetate, 80 mg263157$0
View full utilization report →

Insurance plans in this area (ZIP 72703)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042248445View full group profile
NameSpecialtyState
Orthopedic SurgeryAR
-AR
Certified Clinical Nurse Specialist (Cns)AR
Physician AssistantAR
Physical Therapist In Private PracticeAR
-AR
Physician AssistantAR
Physical Therapist In Private PracticeAR
Orthopedic SurgeryAR
Orthopedic SurgeryAR

Reviews

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Frequently asked questions

What is the standard ID for KENTON LEE HAGAN in the U.S.?
In the U.S., KENTON LEE HAGAN is identified by NPI 1235524653.
Should I treat KENTON LEE HAGAN as an active provider?
Patients and plans typically see KENTON LEE HAGAN as active in the national extract.
What type of care does KENTON LEE HAGAN provide?
KENTON LEE HAGAN's profile centers on Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
What city is tied to KENTON LEE HAGAN?
The directory associates KENTON LEE HAGAN with Fayetteville, Arkansas. Check all listed addresses for suites or satellite offices.
Can I export KENTON LEE HAGAN's record?
You can download the official NPPES record; we summarize key fields for readability.

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