MEDICARE: DR. KATHERINE ALTA HAGMANN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	135.000879	IL
2	213E00000X	Podiatrist	POD-001093	AZ
3	213ES0103X	Foot & Ankle Surgery Podiatrist	1045	MN

General Provider Information

NPI Number	:	1619359510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHERINE ALTA HAGMANN DPM

Provider Business Mailing Address
First Line	:	1155 S POWER RD
Second Line	:	STE 114, #690
City	:	MESA
State	:	AZ
Zip	:	85206
Country	:	US
Telephone Number	:	951-977-3668
Fax Number	:

Provider Business Practice Location Address
First Line	:	16427 N SCOTTSDALE RD STE 410
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254-7102
Country	:	US
Telephone Number	:	888-495-4489
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2015
Last Update Date	:	08/19/2025

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