Robert Jeremy Hackworth, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A81852 Issued in CA

Practice address

34800 Bob Wilson Dr
Nmcsd, Attn: Medical Staff Services
San Diego, CA 92134-1098

Phone

(619) 532-6460

Fax

(619) 532-6299

NPI assigned

Apr 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• County of Los Angeles

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment NPD
• West Hills Anesthesia and Perioperative Physicians

  • Anesthesiology Physician
  • West Hills, CA
  • NPI 1881061802
  Medicare reassignment NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1780877613
  Medicare reassignment
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD
• County of Los Angeles Auditor Controller

  • Clinic/Center
  • Inglewood, CA
  • NPI 1467901652
  NPD

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1891757456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "address_2": "NMCSD, ATTN: MEDICAL STAFF SERVICES",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-6460",
            "fax_number": "619-532-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "address_2": "NMCSD, ATTN: MEDICAL STAFF SERVICES",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-6460",
            "fax_number": "619-532-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKWORTH",
        "first_name": "ROBERT",
        "middle_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A81852",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A81852",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert George Hackim, D.D.S.
• De'Ron Hackler
• Leslie Ann Hackley, R.D.
• Jessica Yvette Hackman, MD, DMD
• Stephanie Hackman, MD
• Shana L. Hackworth
• Alison Hadavi, RDN
• Wayne Hadaway Jr., DDS
• Aida Haddad
• Gabriel George Haddad, M.D.

• Anesthesiology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.