Individual provider Active NPI

Richard Hacker, DPM

  • Podiatrist
  • Middleboro, MA
National Provider Identifier
1114933611
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1740 Issued in MA
Practice address
154 W Grove St
Middleboro, MA 02346-1484
Phone
(508) 947-5355
Fax
(508) 256-8586
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1740 MA Primary

Addresses

Primary practice location

154 W Grove St
Middleboro, MA 02346-1484

Mailing address

154 W Grove St
Middleboro, MA 02346-1484
Phone (508) 947-5355

Other identifiers 4

IdentifierTypeStateIssuer
33040OtherHARVARD PILGRIM
0362387MedicaidMA
33396OtherHARVARD PILGRIM
709822OtherTUFTS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031124000231 MA Practitioner - Podiatry 2466356274 Reassigns benefits to 1 organization
Practice locations: Middleboro, MA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shriver Clinical Services CorporationGroup PAC ID 9739165648, 5 clinicians

Practice addresses (Care Compare)

131 Emerald St
TMC Medical Office
Wrentham, MA 02093-1902
Phone (508) 384-3114

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1836
Removal or shaving of skin growth1727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1740MAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shriver Clinical Services Corporation CurrentSince Mar 24, 2022 Accepting new patients
Richard Hacker PastSince Mar 18, 1994 Accepting new patients

Locations

591 North Ave
#2
Wakefield, MA 01880
Phone (781) 246-8588

Organizations & group practices 2

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1114933611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 W GROVE ST",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023461484",
            "telephone_number": "508-947-5355",
            "fax_number": "508-256-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 W GROVE ST",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023461484",
            "telephone_number": "508-947-5355",
            "fax_number": "508-256-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKER",
        "first_name": "RICHARD",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "33040",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0362387",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "33396",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "709822",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleboro, MA

Sources for this page

Verify at the official NPI Registry.