Joshua Hackenberg, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9112319 Issued in FL

Practice address

777 N Ashley Dr Unit 2007
Tampa, FL 33602-4375

Phone

(570) 490-7195

NPI assigned

Jul 29, 2019

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thrive Behavioral Sciences Tampa LLCGroup PAC ID 2961747506, 22 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Thrive Behavioral Sciences Tampa LLC

  • Psychiatry Physician
  • Tampa, FL
  • NPI 1962989806
  Medicare reassignment Care Compare group
• Ace Behavioral Health LLC

  • Psychiatry Physician
  • Tampa, FL
  • NPI 1841094885
  Medicare reassignment
• Citrus County Rural Health Inc

  • Federally Qualified Health Center (FQHC)
  • Crystal River, FL
  • NPI 1740931831
  Medicare reassignment
• Health Care Center for the Homeless Inc

  • Federally Qualified Health Center (FQHC)
  • Orlando, FL
  • NPI 1235213216
  Medicare reassignment

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1316591324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 N HESPERIDES ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336145414",
            "telephone_number": "813-467-6111",
            "fax_number": "813-467-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N ASHLEY DR UNIT 2007",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024375",
            "telephone_number": "570-490-7195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5510 N Hesperides St",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336145414",
            "country_code": "US",
            "telephone_number": "813-467-6111",
            "fax_number": "813-467-6013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HACKENBERG",
        "first_name": "JOSHUA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-29",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elissa Hachem
• Liset Hachen Castaneda
• Suzana Maria Hachey, PMHNP
• Hacienda Villas Alf
• Taylor Hackal
• Scott Wynn Hacking, M.D.
• Jase R Hackney, D.M.D.
• Noah Hackney, MD
• Ari Hadar, MD
• Wedad Haddabeh, PHARMD

• Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.