Analise Elisabeth Hagstrom, NP
NPI 1104296409ActiveIndividual· Nurse Practitioner· Mill Valley, CA
Nurse Practitioner (NP) in Mill Valley, California, licensed in CA and IL, with an NPI issued in September 2015. Enrolled in Medicare as practitioner - nurse practitioner.
Overview
| NPI | 1104296409 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | NP |
| Sole proprietor | No |
| NPI issued | Sep 29, 2015 |
| Last updated in NPPES | Oct 22, 2025 |
| Certified by provider | Oct 22, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 95003570 | CA |
| Nurse Practitioner, Pediatrics | 363LP0200X | 209012443 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (CA) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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