Individual provider Active NPI

Anna Laura Hackenberg, M.D.

  • Family Medicine Physician
  • Tallahassee, FL
National Provider Identifier
1144666165
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TRN18631 Issued in FL
Practice address
1301 Hodges Dr
Tallahassee, FL 32308-4614
Phone
(850) 431-5714
Fax
(850) 431-6403
NPI assigned
May 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TRN18631 FL Primary

Addresses

Primary practice location

1301 Hodges Dr
Tallahassee, FL 32308-4614

Mailing address

1301 Hodges Dr
Tallahassee, FL 32308-4614
Phone (850) 431-5714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161025000835 CA Practitioner - Family PracticePractitioner - Emergency Medicine 3274758289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

5525 Grossmont Ctr Dr
La Mesa, CA 91942-3009
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Sep 12, 2016 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Family Medicine CurrentSince Sep 12, 2016 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

5525 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 644-6600

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

300 Fir St
San Diego, CA 92101
Phone (619) 446-1586

Interoperability endpoints

  • Direct secure messaging: ahackenberg32625@sharphealthcare.direct-ci.com

Organizations & group practices 4

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": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1144666165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 HODGES DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084614",
            "telephone_number": "850-431-5714",
            "fax_number": "850-431-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 HODGES DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084614",
            "telephone_number": "850-431-5714",
            "fax_number": "850-431-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKENBERG",
        "first_name": "ANNA",
        "middle_name": "LAURA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-16",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN18631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.