Angela B. Hackman, MD
Individual provider Active NPI Geriatric Medicine (Family Medicine) Physician · Beech Grove, IN
NPI 1235366287 · NPPES record last updated Jun 17, 2026
Key facts
- NPI
- 1235366287
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Geriatric Medicine (Family Medicine) Physician 207QG0300X
- License
- 1235366287 (KY)
- Practice address
- 1500 Albany St
Suite 807
Beech Grove, IN 46107-1555 - Phone
- (317) 783-8921
- Fax
- (317) 782-6916
- NPI assigned
- Jun 17, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150827000253 | KY | Practitioner - Geriatric Medicine |
6305085887 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11014993A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vintage Care Inc. | Current |
Accepting new patients |
Locations
2000 Newburg Rd
Louisville, KY 40205
Phone (502) 459-9681
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 1235366287 | KY | Yes |
Addresses
Primary practice location
1500 Albany St
Suite 807
Beech Grove, IN 46107-1555
Mailing address
PO Box 664053
Indianapolis, IN 46266-4053
Phone (317) 783-8921
Other providers in Beech Grove, IN
- Green Medcare LLC
- Greengate Neurobehavioral Health Inc
- Theresa Greenlee
- Danielle Greenwood
- Linda Gritzer
- Krysten Raeanne Harlan
- Helen Hatfield
- Haven and Horizon LLC
- Andrea Lynn Hayes
- Heart Space Mental Health
All providers in Beech Grove, IN · Geriatric Medicine (Family Medicine) Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.