MR. VINCENT T HAGEDORN (PA) – Physician Assistant, NPI 1568602001

MR. VINCENT T HAGEDORN (PA) is a healthcare provider. based in Dallas, Texas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. TEMPLICENSE (TX). The NPI Number for MR. VINCENT T HAGEDORN (PA) is 1568602001

Main info

Male
18 Years Of Experience
Accepts Medicare Assignment
Name
MR. VINCENT T HAGEDORN (PA)
NPI
1568602001
Phone
(214) 361-9777
Address
8220 WALNUT HILL LN
Enumeration Date
24 February 2009
Last Update Date
4 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5124479661
Graduation Year
2008 (18 years ago)
PAC ID
0547327124
Group Practice PAC ID
9739260019
Professional Enrollment ID
I20090326000081
Address ID
TX787047943AU3801XBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness75
Years active:17State licenses:2Digital endpointsOther names

8,497 PHYSICIAN ASSISTANT in TX

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Provider Addresses for MR. VINCENT T HAGEDORN (PA)

  • Walnut Hill Lane, Dallas, Dallas County, Texas, 75231, United States

    SUITE 408

    DALLAS, TX 752314427

    Phone: (214) 361-9777

    Fax: (214) 891-0084

    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: 2009-03-26

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
I20090326000081IPhysician AssistantTXTBD

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
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 75231)

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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: 9739260019View full group profile

Reviews

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Frequently asked questions

Is MR. VINCENT T HAGEDORN (PA) listed with a National Provider Identifier?
Yes — MR. VINCENT T HAGEDORN (PA) has NPI 1568602001 on file in the registry.
Is MR. VINCENT T HAGEDORN (PA) still an active registrant?
MR. VINCENT T HAGEDORN (PA) carries an active NPI according to the public dataset.
What kind of doctor is MR. VINCENT T HAGEDORN (PA)?
MR. VINCENT T HAGEDORN (PA) is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
Where in Texas is MR. VINCENT T HAGEDORN (PA) registered?
Use Dallas, Texas as the headline location for MR. VINCENT T HAGEDORN (PA) here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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