Keenan L Hacker, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5101027749 Issued in MI

Practice address

1675 Leahy St Ste 201
Muskegon, MI 49442-5542

Phone

(231) 672-8289

NPI assigned

Apr 29, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Specialty

Emergency Medicine

Education

Kentucky School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Michigan Emergency Specialists, PLLCGroup PAC ID 0749569242, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health Lakeshore Campus Hospital, Shelby, MI, CCN 231320
• Firsthealth Moore Regional Hospital Hospital, Pinehurst, NC, CCN 340115

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Lake Michigan Emergency Specialists, PLLC

  • Emergency Medicine Physician
  • Muskegon, MI
  • NPI 1124574520
  Medicare reassignment Care Compare group NPD
• Lake Michigan Observation Services PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Muskegon, MI
  • NPI 1518626043
  Medicare reassignment NPD
• Mercy Health Partners

  • Certified Registered Nurse Anesthetist
  • Shelby, MI
  • NPI 1154910172
  Medicare reassignment NPD
• Mercy Health Partners

  • Rural Health Clinic/Center
  • Whitehall, MI
  • NPI 1326463357
  NPD

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

• Mercy Health Partners

  • Critical Access Hospital
  • Shelby, MI
  • NPI 1285662981
  Care Compare affiliation
• Firsthealth of the Carolinas, Inc

  • Obesity Medicine (Internal Medicine) Physician
  • Pinehurst, NC
  • NPI 1740463967

  Hospital

  Care Compare affiliation
• Firsthealth of the Carolinas, Inc

  • Land Ambulance
  • Pinehurst, NC
  • NPI 1871610378

  Hospital

  Care Compare affiliation
• Firsthealth of the Carolinas, Inc.

  • Oncology Clinic/Center
  • Pinehurst, NC
  • NPI 1417010422

  Hospital

  Care Compare affiliation
• Firsthealth of the Carolinas, Inc.

  • General Acute Care Hospital
  • Pinehurst, NC
  • NPI 1740208081
  Care Compare affiliation

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1295470623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 LEAHY ST STE 201",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 LEAHY ST STE 201",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425542",
            "telephone_number": "231-672-8289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "905 E Colby St",
            "address_purpose": "LOCATION",
            "city": "Whitehall",
            "state": "MI",
            "postal_code": "494611262",
            "country_code": "US",
            "telephone_number": "231-672-8050",
            "fax_number": "231-672-8048",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5656 W US Highway 10",
            "address_purpose": "LOCATION",
            "city": "Ludington",
            "state": "MI",
            "postal_code": "494312454",
            "country_code": "US",
            "telephone_number": "231-843-2543",
            "fax_number": "231-843-2547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HACKER",
        "first_name": "KEENAN",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-29",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101027749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally Ruth Haadsma
• Jennifer Haak
• Lindsey Haan, LLMSW
• Tamara Jean Haase
• Lisa Hackbarth
• Hackley Community Care Center Inc
• Hackley Community Care Center Inc
• Hackley Community Care Center Inc
• Hackley Community Care Center Inc
• Hackley Community Care Center Inc

• Emergency Medicine Physician in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.

Verify at the official NPI Registry.