Active NPI
Timothy B Hacker, MD
- Internal Medicine Physician
- Toledo, OH
National Provider Identifier
1013915289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35037540
- Practice address
- 4640 W Alexis Rd
Toledo, OH 43623-1006 - Phone
- (419) 843-8150
- Fax
- (419) 479-2579
- NPI assigned
- Jul 12, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35037540 | OH | Primary |
Addresses
Primary practice location
4640 W Alexis Rd
Toledo, OH 43623-1006
Mailing address
4640 W Alexis Rd
Toledo, OH 43623-1006
Phone (419) 843-8150
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04-02982 | Other | OH | UHC |
| 00153 | Other | OH | PARAMOUNT |
| 0639351 | Other | OH | AETNA |
| 000000141198 | Other | OH | ANTHEM |
| 0375277 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35037540 | OH | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promedica Central Physicians | Internal Medicine | Current | Accepting new patients |
Locations
2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111
2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112
4640 W Alexis Rd
Toledo, OH 43623
Phone (419) 474-9324
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1013915289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4640 W ALEXIS RD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436231006",
"telephone_number": "419-843-8150",
"fax_number": "419-479-2579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4640 W ALEXIS RD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436231006",
"telephone_number": "419-843-8150",
"fax_number": "419-479-2579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKER",
"first_name": "TIMOTHY",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35037540",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "04-02982",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARAMOUNT",
"identifier": "00153",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0639351",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000141198",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0375277",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.