SANDY R HAGENE (FNP) – Family Nurse Practitioner, NPI 1184731671

SANDY R HAGENE (FNP) is a healthcare provider. based in Sullivan, Missouri. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 112906 (MO). The NPI Number for SANDY R HAGENE (FNP) is 1184731671

Main info

Female
29 Years Of Experience
Accepts Medicare Assignment
Name
SANDY R HAGENE (FNP)
NPI
1184731671
Phone
(573) 860-6000
Address
965 Mattox Dr
Enumeration Date
23 August 2006
Last Update Date
13 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5738606600
Graduation Year
1997 (29 years ago)
PAC ID
7810095239
Group Practice PAC ID
2668380148
Professional Enrollment ID
I20070608000409
Address ID
MO654531664CU102XXDRXX301

Contacts

FHIR Endpoint
https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

7,017 NURSE PRACTITIONER in MO

Provider Addresses for SANDY R HAGENE (FNP)

  • 965 Mattox Dr

    Sullivan, MO 630802365

    Phone: (573) 860-6000

    Type: Location

  • 102 OZARK DR STE B

    CUBA, MO 654531664

    Phone: (573) 885-6600

    Type: Mailing

  • 670, Mason Ridge Center Drive, Town and Country, Saint Louis County, Missouri, 63141, United States

    STE 300

    SAINT LOUIS, MO 631418573

    Phone: (573) 885-6600

    Fax: (573) 885-6610

    Type: Mailing

  • Ozark Drive, Cuba, Crawford County, Missouri, 65453, United States

    CUBA, MO 65453

    Phone: (573) 885-6600

    Fax: (573) 885-6610

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 37 Open Payments records for all available years, with a total value of $612.

Total Amount is formed as General ($612) + Research ($0) + Ownership ($0) = $612.

Last reported payment date: 2024-09-19 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($188).

Total Amount

$612

General + Research + Ownership

Payments

37

Total payment records

General Amount

$612

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2007-06-08

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
I20070608000409INurse PractitionerMOTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63080)

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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: 2668380148View full group profile
NameSpecialtyState
Nurse PractitionerMO
Nurse PractitionerMO
Internal MedicineMO
General SurgeryMO
-MO
Hospitalist, Internal MedicineAR
Physician AssistantMO
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerMO

Reviews

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Frequently asked questions

What federal number belongs to SANDY R HAGENE (FNP)?
The federal identifier for SANDY R HAGENE (FNP) is NPI 1184731671.
Does this profile mean SANDY R HAGENE (FNP) is currently active?
Yes — SANDY R HAGENE (FNP) appears active in the national provider directory.
What field does SANDY R HAGENE (FNP) work in?
You can think of SANDY R HAGENE (FNP) as practicing within Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place SANDY R HAGENE (FNP)?
The snapshot lists Sullivan, Missouri for SANDY R HAGENE (FNP); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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