NPIMap

Individual provider Active NPI

Patricia Ann Hackenburg

  • Family Nurse Practitioner
  • Lorain, OH
National Provider Identifier
1801394085
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.021824 Issued in OH
Practice address
5940 Oak Point Rd
Lorain, OH 44053-4100
Phone
(440) 988-3705
Fax
(440) 988-7433
NPI assigned
Jan 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.021824 OH Primary

Addresses

Primary practice location

5940 Oak Point Rd
Lorain, OH 44053-4100

Mailing address

5940 Oak Point Rd
Lorain, OH 44053-4100
Phone (440) 988-3705

Other names 1

  • Patricia Ann Hofelich Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180416002668 OH Practitioner - Nurse Practitioner 6002179520 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Coast Professional Company, LLCGroup PAC ID 6305810201, 105 clinicians

Practice addresses (Care Compare)

1470W McPherson Hwy
Clyde, OH 43410-1010
Phone (419) 547-0700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health-Allen Hospital LLC CurrentSince Aug 19, 2019 Accepting new patients
North Coast Professional Company, LLC CurrentSince Sep 3, 2019 Accepting new patients
Mercy Health-Allen Hospital LLC CurrentSince Aug 19, 2019 Accepting new patients
North Coast Professional Company, LLC CurrentSince Sep 3, 2019 Accepting new patients
Mercy Health Physicians Lorain, LLC CurrentSince Aug 19, 2019 Accepting new patients
Mercy Health-Allen Hospital LLC Current Accepting new patients
Mercy Health Physicians, Lorain, LLC CurrentSince Aug 19, 2019 Accepting new patients
Sandusky Wellness DME LLC PastSince Mar 4, 2018 Accepting new patients

Locations

578 N Leavitt Rd
Amherst, OH 44001
Phone (440) 960-3912

1470 W McPherson Hwy
Clyde, OH 43410
Phone (419) 547-0700

1120 E Broad St
Elyria, OH 44035
Phone (440) 365-2600

5940 Oak Point Rd
Lorain, OH 44053
Phone (440) 988-3705

703 Tyler St
Ste 352
Sandusky, OH 44870
Phone (419) 557-6785

840 Patriot Dr
Wellington, OH 44090
Phone (440) 647-2225

Interoperability endpoints

  • Direct secure messaging: patricia.hackenburg@fpg.medicity.net

Organizations & group practices 8

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 5

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": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1801394085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5940 OAK POINT RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440534100",
            "telephone_number": "440-988-3705",
            "fax_number": "440-988-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5940 OAK POINT RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440534100",
            "telephone_number": "440-988-3705",
            "fax_number": "440-988-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKENBURG",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-23",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.021824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "HOFELICH",
            "middle_name": "ANN",
            "credential": "FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.