Individual provider Active NPI

James Brian Hacker, CRNA, DNAP

  • Certified Registered Nurse Anesthetist
  • Fort Hood, TX
National Provider Identifier
1174708986
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NATL CERT # 077959 Issued in PA
Practice address
36065 Santa Fe Ave
Fort Hood, TX 76544-5060
Phone
(254) 288-8473
NPI assigned
Dec 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN521960L PA
Certified Registered Nurse Anesthetist 367500000X NATL CERT # 077959 PA Primary

Addresses

Primary practice location

36065 Santa Fe Ave
Fort Hood, TX 76544-5060

Mailing address

9040 Fitzsimmons Drive
Tacoma, WA 98431-1100
Phone (253) 967-7408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220228001818 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820482367 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penn State Health Medical Group LLCGroup PAC ID 8729351077, 720 clinicians

Practice addresses (Care Compare)

503 N 21St St
Camp Hill, PA 17011-2204
Phone (717) 234-2561

Hospital & facility affiliations

  • Penn State Health Hampden Medical Center Hospital, Enola, PA, CCN 390336

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN521960LPAMDRegistered Nurse
NATL CERT # 077959PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2024 Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2024 Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients
West Shore Anesthesia Associates, LTD CurrentSince Dec 1, 2021 Accepting new patients
North American Partners in Anesthesia, Pennsylvania , LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 6, 2024 Accepting new patients

Locations

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

2200 Good Hope Rd
Ste 1076
Enola, PA 17025
Phone (717) 981-8160

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1174708986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 FITZSIMMONS DRIVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-967-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36065 SANTA FE AVE",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765445060",
            "telephone_number": "254-288-8473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKER",
        "first_name": "JAMES",
        "middle_name": "BRIAN",
        "credential": "CRNA, DNAP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-31",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN521960L",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "NATL CERT # 077959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Hood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.