Mark Hacker, P.A.-C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.002469 Issued in OH

Practice address

1320 West Main St
Newark, OH 43055

Phone

(220) 564-4151

Fax

(220) 564-7153

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH, CA2 enrollments

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 2

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osu Emergency Medicine LLCGroup PAC ID 2668386673, 169 clinicians

Osu Observation Medicine, LLCGroup PAC ID 3375692270, 423 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Osu Emergency Medicine LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Columbus, OH
  • NPI 1699705681
  Medicare reassignment Care Compare group
• Osu Observation Medicine, LLC

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1407095052
  Medicare reassignment Care Compare group
• Emergency Physicians Urgent Care Inc.

  • Urgent Care Clinic/Center
  • Bakersfield, CA
  • NPI 1689963845
  Medicare reassignment NPD
• Wedgewood Urgent Care, LTD

  • Family Medicine Physician
  • Powell, OH
  • NPI 1487601167
  Medicare reassignment
• Licking Memorial Professional Corp.

  • Pediatrics Physician
  • Utica, OH
  • NPI 1497771521
  NPD (past)

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

• Ohio State University Hospitals

  • Rehabilitation Hospital Unit
  • Columbus, OH
  • NPI 1184723637
  Care Compare affiliation
• Ohio State University Hospitals

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1447359997
  Care Compare affiliation
• Ohio State University Hospitals

  • Psychiatric Hospital Unit
  • Columbus, OH
  • NPI 1790876183
  Care Compare affiliation

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1861591836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 WEST MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "43055",
            "telephone_number": "220-564-4151",
            "fax_number": "220-564-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WEST MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "43055",
            "telephone_number": "220-564-4151",
            "fax_number": "220-564-7153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 W Main St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430551822",
            "country_code": "US",
            "telephone_number": "220-564-7153",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1320 W Main St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430551822",
            "country_code": "US",
            "telephone_number": "220-564-7153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HACKER",
        "first_name": "MARK",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50002469RX",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "53306",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.002469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhacker14462@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "endpointDescription": "DIRECT EMAIL ADDRESS",
            "affiliationName": "LICKING MEMORIAL PROFESSIONAL CORPORATION",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "OTHER",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhacker14462@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "endpointDescription": "DIRECT EMAIL ADDRESS",
            "affiliationName": "LICKING MEMORIAL PROFESSIONAL CORPORATION",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "OTHER",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tyler Guminski
• Subash Gurung, PT
• Debra Ann Gustafson, L.P.N.
• H2 Rehabilitation Services of Ohio LLC
• Lauren Cathryn Haas, MSW 1
• Alexandra Marie Haffner, CNP
• Thomas J Hagele
• Saad A. Hagras
• Virginia S Haines, LISW-S
• Courtney A Haley

• Physician Assistant in Newark, OH
• Providers in Newark, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.