Nicole M Hackman, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD439900 Issued in PA

Practice address

35 Hope Drive
Stes 102 & 104
Hershey, PA 17033-2086

Phone

(717) 531-7300

Fax

(717) 531-3527

NPI assigned

Jun 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nicole Dague Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

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.

• The Milton S Hershey Medical Center Physicians Group

  • Orthopaedic Surgery Physician
  • Hershey, PA
  • NPI 1710951744
  Medicare reassignment NPD
• The Milton S Hershey Medical Center Physician Group

  • Body Imaging Physician
  • Hershey, PA
  • NPI 1346215928
  NPD
• The Milton S Hershey Medical Center Physicians Group

  • Pediatrics Physician
  • Hershey, PA
  • NPI 1205801537
  NPD
• The Milton S Hershey Medical Center

  • General Acute Care Hospital
  • Hershey, PA
  • NPI 1568435477
  NPD (past)
• The Milton S. Hershey Medical Center Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Hershey, PA
  • NPI 1255482089
  NPD (past)

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1912109158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MC A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 HOPE DRIVE",
            "address_2": "STES 102 & 104",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332086",
            "telephone_number": "717-531-7300",
            "fax_number": "717-531-3527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_2": "H088",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-8006",
            "fax_number": "717-531-0869",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 Hope Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332036",
            "country_code": "US",
            "telephone_number": "717-531-7300",
            "fax_number": "717-531-3527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HACKMAN",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD439900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024833480002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "DAGUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nhuna Ha
• Aaron Lee Haag, DO
• Kristin Haag
• Sabeen Y Habib, M.D.
• Gretchen Louise Hackett, D.O.
• Mohammad Amin Hadavand
• David Floyd Haddock, MD
• Frances Hadley, DIETICIAN
• William Jonathan Haff
• Sarah Hafiz, DO

• Pediatrics Physician in Hershey, PA
• Providers in Hershey, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; 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.