Individual provider Active NPI

Gail Jean Hacker, MD

  • Family Medicine Physician
  • Eugene, OR
National Provider Identifier
1235252248
Registry record updated Aug 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD 21490 Issued in OR
Practice address
3579 Franklin Blvd
Eugene, OR 97403-2356
Phone
(541) 344-9411
Fax
(541) 342-6088
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2014

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 MD 21490 OR Primary

Addresses

Primary practice location

3579 Franklin Blvd
Eugene, OR 97403-2356

Mailing address

3579 Franklin Blvd
Eugene, OR 97403-2356
Phone (541) 344-9411

Other identifiers 1

IdentifierTypeStateIssuer
151323MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140709000217 TX Practitioner - Family Practice 2567687411 Reassigns benefits to 1 organization
I20141218001401 OR Practitioner - Family Practice 2567687411 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 21490ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HIV Alliance CurrentSince Jul 22, 2022 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Jun 11, 2014 Accepting new patients
DHHS, PHS, Naihs, Gallup Indian Medical Center CurrentSince Jun 11, 2014 Accepting new patients
Lane County Oregon CurrentSince Oct 27, 2014 Accepting new patients

Locations

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

1022 Green Acres Rd
Eugene, OR 97408
Phone (541) 682-3551

1195 City View St
#A
Eugene, OR 97402
Phone (541) 342-5088

2073 Olympic St
Springfield, OR 97477
Phone (541) 682-3530

Interoperability endpoints

  • Direct secure messaging: gail.hacker.1@20257.direct.athenahealth.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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1235252248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3579 FRANKLIN BLVD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974032356",
            "telephone_number": "541-344-9411",
            "fax_number": "541-342-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3579 FRANKLIN BLVD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974032356",
            "telephone_number": "541-344-9411",
            "fax_number": "541-342-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKER",
        "first_name": "GAIL",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD 21490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151323",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.