Active NPI
Ronald A Hackelman, DPM
- Podiatrist
- Detroit, MI
National Provider Identifier
1326153537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 001370
- Practice address
- 634 Chene Street
Detroit, MI 48207 - Phone
- (313) 259-2210
- Fax
- (248) 488-1048
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 001370 | MI | Primary |
Addresses
Primary practice location
634 Chene Street
Detroit, MI 48207
Mailing address
29264 Laurel Dr
Farmington Hills, MI 48331
Phone (248) 488-1959
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1773251 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001370 | MI | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Podcare PC | Podiatrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Podiatrist
- Rochester Hills, MI
- NPI 1942512710
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267401600000",
"number": "1326153537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29264 LAUREL DR",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "48331",
"telephone_number": "248-488-1959",
"fax_number": "248-488-1048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "634 CHENE STREET",
"city": "DETROIT",
"state": "MI",
"postal_code": "48207",
"telephone_number": "313-259-2210",
"fax_number": "248-488-1048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKELMAN",
"first_name": "RONALD",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2010-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MI",
"license": "001370",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1773251",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.