Active NPI
Jason Vanvliet Hackett, M.D.
- Family Medicine Physician
- Gainesville, VA
National Provider Identifier
1255327128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0101237490
- Practice address
- 7915 Lake Manassas Dr Ste 102
Gainesville, VA 20155-3259 - Phone
- (703) 754-4101
- Fax
- (703) 754-1105
- NPI assigned
- Sep 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101237490 | VA | Primary |
Addresses
Primary practice location
7915 Lake Manassas Dr Ste 102
Gainesville, VA 20155-3259
Mailing address
7915 Lake Manassas Dr Ste 102
Gainesville, VA 20155-3259
Phone (703) 754-4101
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F532 0007 | Other | DC | CAREFIRST |
| 178868 | Other | VA | ANTHEM BC/BS |
| 7644715 | Other | AETNA | |
| 3830222 | Other | VA | AETNA HMO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7915 Lake Manassas Dr
Suite 102
Gainesville, VA 20155-3259
Phone (703) 754-4101
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101237490 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gainesville Family Practice, P.C. | Family Medicine | Current | Accepting new patients |
| Nova Medical and Urgent Care Center, Inc. | Family Medicine | Past | Accepting new patients |
Locations
14370 Lee Hwy
Ste 105
Gainesville, VA 20155
Phone (703) 369-8077
7915 Lake Manassas Dr
Ste 102
Gainesville, VA 20155
Phone (703) 754-4101
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JJIEBA/Endpoint/JJIEBA
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.
-
- Family Medicine Physician
- Gainesville, VA
- NPI 1871589770
-
dba Nova Medical Group, Nova Urgent Care
- Family Medicine Physician
- Ashburn, VA
- NPI 1588683742
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Inova Fairfax Hospital
- Rehabilitation Hospital Unit
- Falls Church, VA
- NPI 1588795462
-
dba Inova Fairfax Hospital
- General Acute Care Hospital
- Falls Church, VA
- NPI 1831220714
-
dba UVA Health Haymarket Medical Center
- General Acute Care Hospital
- Haymarket, VA
- NPI 1124369137
-
dba UVA Health Prince William Medical Center
- General Acute Care Hospital
- Manassas, VA
- NPI 1417005760
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664323200000",
"number": "1255327128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7915 LAKE MANASSAS DR STE 102",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "201553259",
"telephone_number": "703-754-4101",
"fax_number": "703-754-1105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7915 LAKE MANASSAS DR STE 102",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "201553259",
"telephone_number": "703-754-4101",
"fax_number": "703-754-1105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKETT",
"first_name": "JASON",
"middle_name": "VANVLIET",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-26",
"last_updated": "2022-09-28",
"certification_date": "2022-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0101237490",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST",
"identifier": "F532 0007",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "178868",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7644715",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "3830222",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.