LISA HAGERTY (DPT) – Physical Therapist, NPI 1619353588

LISA HAGERTY (DPT) is a healthcare provider. based in Callahan, Florida. specializing in Physical Therapist. They hold the professional credentials DPT. They hold a License No. PT 30351 (FL). The NPI Number for LISA HAGERTY (DPT) is 1619353588

Main info

Female
Sole Proprietor
Name
LISA HAGERTY (DPT)
NPI
1619353588
Phone
(904) 879-1223
Address
PO BOX 1609
Enumeration Date
3 August 2015
Last Update Date
4 December 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness85
Years active:10State licenses:1Digital endpointsOther names

Provider Addresses for LISA HAGERTY (DPT)

  • PO BOX 1609

    CALLAHAN, FL 320111609

    Phone: (904) 879-1223

    Fax: (904) 879-4986

    Type: Mailing

  • 45390 GREEN AVE

    CALLAHAN, FL 320113711

    Phone: (904) 879-1223

    Fax: (907) 879-4986

    Type: Location

  • 465 S LAWRENCE BLVD

    KEYSTONE HEIGHTS, FL 326569222

    Phone: (352) 473-7560

    Type: Mailing

  • 3599 UNIVERSITY BLVD S

    JACKSONVILLE, FL 322164252

    Phone: (904) 879-1223

    Fax: (904) 879-4986

    Type: Mailing

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: 2015-09-16

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
I20150916000755IPhysical Therapist In Private PracticeFLTBD

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 32011)

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Reviews

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Frequently asked questions

How do I look up LISA HAGERTY (DPT) by NPI?
Use NPI 1619353588 when you need to reference LISA HAGERTY (DPT) in forms, claims, or directories.
Does this profile mean LISA HAGERTY (DPT) is currently active?
Yes — LISA HAGERTY (DPT) appears active in the national provider directory.
What does LISA HAGERTY (DPT) treat or focus on?
Patients typically see LISA HAGERTY (DPT) under the specialty Physical Therapist. Clinical services aligned with this taxonomy classification.
Where does public data place LISA HAGERTY (DPT)?
The snapshot lists Callahan, Florida for LISA HAGERTY (DPT); 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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