Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kyle Jay Hagen, PA-C

Individual provider Physician Assistant · NPI 1578093258

Kyle Jay Hagen, PA-C is a Physician Assistant in Wauwatosa, Wisconsin. Qualified in 2017, 9 years ago. Practices with The Medical College of Wisconsin Inc, a 2,093-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
9
Licensed in
WI
In the registry since
2017
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

10000 W Bluemound Rd
Wauwatosa, WI 53226-4321
Phone: (414) 805-5320
Fax: (414) 805-5323
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4038 (WI)

Record details

NPI number1578093258
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 15, 2017
Last updated in NPPESApril 3, 2025
Certification dateApril 3, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice The Medical College Of Wisconsin Inc — 2093 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Wauwatosa