Individual provider Active NPI

Susan Lynn Hackworth, PA-C

  • Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1174557680
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA 002831L Issued in PA
Practice address
3720 Brownsville Rd
Pittsburgh, PA 15227-3520
Phone
(412) 882-9455
Fax
(412) 884-6149
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA 002831L PA Primary

Addresses

Primary practice location

3720 Brownsville Rd
Pittsburgh, PA 15227-3520

Mailing address

3720 Brownsville Rd
Pittsburgh, PA 15227-3520
Phone (412) 882-9455

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061107000051 PA Practitioner - Physician Assistant 6103823034 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA 002831LPAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care P.a. CurrentSince Mar 4, 2019 Accepting new patients
American Current Care PA CurrentSince Mar 4, 2019 Accepting new patients

Locations

2010 Levick St
Philadelphia, PA 19149
Phone (215) 537-4755

15 Freeport Rd
Ste 100
Pittsburgh, PA 15215
Phone (412) 784-1551

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1174557680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 BROWNSVILLE RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152273520",
            "telephone_number": "412-882-9455",
            "fax_number": "412-884-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 BROWNSVILLE RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152273520",
            "telephone_number": "412-882-9455",
            "fax_number": "412-884-6149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKWORTH",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA 002831L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.