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DUSTY RENEE HACKLER PHD
NPI 1487168357
Psychologist - Clinical Child & Adolescent in Maple Grove, MN

Active since November 29, 2017PECOS Enrolled
9555 UPLAND LN N, MAPLE GROVE, MN 55369(952) 993-3307 Get Directions Write a Review

NPPES record last updated: November 29, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dusty Renee Hackler Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DUSTY RENEE HACKLER PHD (NPI 1487168357) is an individual clinical child & adolescent provider in Maple Grove, Minnesota, licensed in Minnesota (LP6194) and active in the NPI registry since November 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1487168357
Entity TypeIndividualFemale
Primary Taxonomy103TC2200X
Provider Legal NameDUSTY RENEE HACKLERCredential: PHD
Location Address9555 UPLAND LN NMaple Grove, MN 55369-4485
Mailing Address9555 Upland Ln N, Mailstop:62m03bMaple Grove, MN 55369-4485 · (952) 993-3307
Phone(952) 993-3307
Sole ProprietorNo
Enumeration DateNovember 29, 2017
✔ NPI 1487168357 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers
Taxonomy Code103TC2200X
License✔ Licensed in MN · LP6194
Definition
A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.
9555 UPLAND LN N, Maple Grove, MN 55369
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dusty Renee Hackler Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Dusty Hackler reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Park Nicollet Clinic
5.4 mi
Family Medicine
7000 TARGET PKWY N
Brooklyn Park, MN 55445
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,527 clinicians in this Medicare group
NPI 1447668678 (952) 977-1985

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID JEWISON M.D.
Family Medicine (Sports Medicine)
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Hennepin County (952) 831-8742
MICHELLE K. PEMBLE-FRAZEY PHD
Psychologist (Cognitive & Behavioral)
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Hennepin County (952) 993-1440
MRS. REBEKKA MCCLURE MA, LMFT
Marriage & Family Therapist
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Hennepin County (952) 993-1440
NATASHA MARIE MILLS
Psychologist
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Hennepin County (952) 993-1440
NICKOLAS WILLIAMS
Psychiatry & Neurology (Psychiatry)
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Hennepin County (952) 993-1440
REANN JO MCGUIRE DNP, APRN, FNP-C
Nurse Practitioner (Family)
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Hennepin County (952) 993-1440
DANIEL KEELEY MD
Internal Medicine
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Hennepin County (952) 993-1440
DR. MICHAEL H FARRELL MD
Pediatrics
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Hennepin County (952) 993-1440

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dusty Hackler's NPI number?

The NPI number for Dusty Hackler is 1487168357. It was assigned to this individual provider in the NPPES registry on November 29, 2017.

Where is Dusty Hackler located?

Dusty Hackler practices at 9555 Upland Ln N, Maple Grove, MN 55369. The listed phone number is (952) 993-3307.

What is Dusty Hackler's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Is Dusty Hackler enrolled in Medicare?

Yes. Dusty Hackler is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Dusty Hackler's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dusty Hackler reassigns Medicare benefits to Park Nicollet Clinic (Brooklyn Park, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dusty Hackler's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dusty Hackler accept?

Health plans from HealthPartners list Dusty Hackler as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dusty Hackler was last updated on November 29, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.