NPIMap

Individual provider Active NPI

Jacob Mathias Hakkola, MD

  • Vascular & Interventional Radiology Physician
  • Marquette, MI
National Provider Identifier
1437592250
Registry record updated Dec 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
4301500444 Issued in MI
Practice address
850 W Baraga Ave
Marquette, MI 49855-4550
Phone
(906) 449-3495
Fax
(906) 449-1939
NPI assigned
Apr 11, 2013
Last updated
Dec 21, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Vascular & Interventional Radiology Physician 2085R0204X 4301500444 MI Primary

Addresses

Primary practice location

850 W Baraga Ave
Marquette, MI 49855-4550

Mailing address

850 W. Baraga Avenue
Interventional Radiology - Suite 20
Marquette, MI 49855
Phone (906) 449-3440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191004001070 MI Practitioner - Diagnostic Radiology 7911202049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Minnesota Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

580 W College Ave
Marquette, MI 49855-2736
Phone (906) 225-3995

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301500444MIMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2019 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2019 Accepting new patients

Locations

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

850 W Baraga Ave
Marquette, MI 49855
Phone (906) 225-3595

850 W Baraga Ave
Ste 20
Marquette, MI 49855
Phone (906) 449-3440

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: jacob.hakkola.1@8233.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576886400000",
    "number": "1437592250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W. BARAGA AVENUE",
            "address_2": "INTERVENTIONAL RADIOLOGY - SUITE 20",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-449-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W BARAGA AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554550",
            "telephone_number": "906-449-3495",
            "fax_number": "906-449-1939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKKOLA",
        "first_name": "JACOB",
        "middle_name": "MATHIAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2019-12-21",
        "certification_date": "2019-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MI",
            "license": "4301500444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.