NPIMap

Individual provider Active NPI

Joshua Gilman Hackel, MD

  • Sports Medicine (Family Medicine) Physician
  • Gulf Breeze, FL
National Provider Identifier
1225020936
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
ME 91174 Issued in FL
Practice address
1040 Gulf Breeze Pkwy
Suite 200
Gulf Breeze, FL 32561-7809
Phone
(850) 916-3700
Fax
(850) 916-3710
NPI assigned
Aug 18, 2005
Last updated
Jan 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X ME 91174 FL Primary

Addresses

Primary practice location

1040 Gulf Breeze Pkwy
Suite 200
Gulf Breeze, FL 32561-7809

Mailing address

1040 Gulf Breeze Pkwy Ste 200
Gulf Breeze, FL 32561-7808
Phone (850) 916-3700

Other identifiers 4

IdentifierTypeStateIssuer
50284OtherFLBLUE CROSS BLUE SHIELD
110611MedicaidAL
591-82235OtherALBLUE CROSS BLUE SHIELD
273585700MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050917000029 FL Practitioner - Sports MedicinePractitioner - Other (Physician)Practitioner - Family Practice 5395733489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

11945 San Jose Blvd
Jacksonville, FL 32223-1627
Phone (904) 396-1725

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 91174FLMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Aug 1, 2022 Accepting new patients
North Florida Surgeons, PA CurrentSince Aug 1, 2022 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Panhandle Outpatient Surgery Center Past Accepting new patients
Alabama Sports Medicine and Ortho Center Past Accepting new patients
Andrews Sports Medicine and Orthopaedic Center Past Accepting new patients

Locations

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

836 Prudential Dr
Ste 1001
Jacksonville, FL 32207
Phone (904) 398-0004

4012 N 9th Ave
Pensacola, FL 32503
Phone (850) 444-4777

1040 Gulf Breeze Pkwy
Ste 200
Pensacola Beach, FL 32561
Phone (850) 916-8711

Interoperability endpoints

  • Direct secure messaging: josh.hackel.1@9109.direct.athenahealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1225020936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 GULF BREEZE PKWY STE 200",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325617808",
            "telephone_number": "850-916-3700",
            "fax_number": "850-916-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 GULF BREEZE PKWY",
            "address_2": "SUITE 200",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325617809",
            "telephone_number": "850-916-3700",
            "fax_number": "850-916-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKEL",
        "first_name": "JOSHUA",
        "middle_name": "GILMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME 91174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "50284",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110611",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "591-82235",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273585700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

Verify at the official NPI Registry.