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MR. KEITH J HACKER P.A.
NPI 1952508400
Physician Assistant in Port Washington, WI

Active since June 28, 2007
1777 W GRAND AVE, PORT WASHINGTON, WI 53074(262) 284-3456 Get Directions Write a Review

NPPES record last updated: November 23, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 23, 2021, Oct 14, 2016, Jun 13, 2016 (3 updates tracked since 2016).

About Mr. Keith J Hacker P.a. NPPES

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

MR. KEITH J HACKER P.A. (NPI 1952508400) is an individual physician assistant in Port Washington, Wisconsin, licensed in Wisconsin (523) and active in the NPI registry since June 2007.

NPPES Registry Identity

NPI1952508400
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. KEITH J HACKERCredential: P.A.
Location Address1777 W GRAND AVEPort Washington, WI 53074-2077
Mailing Address1777 W Grand AvePort Washington, WI 53074-2077 · (262) 284-3456
Phone(262) 284-3456
Sole ProprietorNo
Enumeration DateJune 28, 2007
Last NPPES UpdateNovember 23, 20213 updates tracked since enumeration
NPPES CertifiedNovember 23, 2021
✔ NPI 1952508400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in WI · 523
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1777 W GRAND AVE, Port Washington, WI 53074
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Other Identifiers 1

Medicaid1952508400WI

Other Providers at the Same Location NPPES 13

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

KENNETH F. JENSEN JR. M.D.
Internal Medicine
1777 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 284-3456
STEPHANIE M MAVES MD
Family Medicine
1777 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 284-3456
DR. TERRY R ZIEGLER D.C.
Chiropractor
1777 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 284-3456
DAWN M ZAK MS, LPC, CSAC
Counselor (Addiction (Substance Use Disorder))
1777 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 268-6637
ADVANCED HEALTHCARE, S.C.
Durable Medical Equipment & Medical Supplies
1777 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 284-3456
HEIDI S WHEELER NP
Nurse Practitioner
1777 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 268-6603
AURORA ADVANCED HEALTHCARE, INC.
Eyewear Supplier
1777 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 284-3456
ADVANCED HEALTHCARE, S.C.
Clinical Medical Laboratory
1777 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 284-3456

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 Keith Hacker's NPI number?

The NPI number for Keith Hacker is 1952508400. It was assigned to this individual provider in the NPPES registry on June 28, 2007.

Where is Keith Hacker located?

Keith Hacker practices at 1777 W Grand Ave, Port Washington, WI 53074. The listed phone number is (262) 284-3456.

What is Keith Hacker's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Keith Hacker was last updated on November 23, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.