Individual provider Active NPI

Christopher Barton Hackett, PA-C

  • Physician Assistant
  • Sharonville, OH
National Provider Identifier
1497238844
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.005640RX Issued in OH
Practice address
12089 Lebanon Rd
Sharonville, OH 45241-1703
Phone
(513) 914-5002
NPI assigned
Sep 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.005640RX OH Primary

Addresses

Primary practice location

12089 Lebanon Rd
Sharonville, OH 45241-1703

Mailing address

12089 Lebanon Rd
Sharonville, OH 45241-1703
Phone (513) 915-5002

Other practice location 1

276 W Crest Dr
Cincinnati, OH 45215-3703
Phone (859) 512-5025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20181018001693 OH Practitioner - Physician Assistant 0143573238 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722

450 N Hyatt St
Suite 304
Tipp City, OH 45371-1433
Phone (937) 832-4773

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
66.25
Promoting interoperability
100
Improvement activities
40
Cost
71.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.005640RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Aug 2, 2021 Accepting new patients
Premier Health Specialists Inc CurrentSince Aug 2, 2021 Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

1 Wyoming St
Ste 4130
Dayton, OH 45409
Phone (937) 208-6810

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

3170 Kettering Blvd
Bldg B3
Moraine, OH 45439
Phone (937) 991-3188

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1497238844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12089 LEBANON RD",
            "city": "SHARONVILLE",
            "state": "OH",
            "postal_code": "452411703",
            "telephone_number": "513-915-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12089 LEBANON RD",
            "city": "SHARONVILLE",
            "state": "OH",
            "postal_code": "452411703",
            "telephone_number": "513-914-5002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "276 W Crest Dr",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452153703",
            "country_code": "US",
            "telephone_number": "859-512-5025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HACKETT",
        "first_name": "CHRISTOPHER",
        "middle_name": "BARTON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-12",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005640RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sharonville, OH

Sources for this page

Verify at the official NPI Registry.