Keith J Hacker , PA
Physician Assistant • Port Washington, WI
1777 W Grand Ave
Port Washington, WI 530742077
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
Practice Location & Contact Primary Location
1777 W Grand Ave
Port Washington, WI 530742077
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
What Public CMS Data Show
Physician Assistant: NPPES taxonomy is a reported classification, not proof of board certification.
Industry payments (Open Payments)
No Open Payments records are listed for this clinician for 2021–2025.
NPI first issued
2007
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.
Compared with the same specialty in Port Washington and Wisconsin
6 active clinicians are listed under Physician Assistant with a practice address in Port Washington, WI (3,519 in Wisconsin).
Addresses are self-reported to NPPES and may be out of date.
Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2021-11-23NUCC Taxonomy Code: 363A00000X
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.
Additional State Medicaid & Healthcare Payer Identifiers
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Internal Medicine
Doctor of Medicine (M.D.)
Pediatrics
Doctor of Medicine (M.D.)
Family Medicine
Doctor of Medicine (M.D.)
Chiropractor
Doctor of Chiropractic
Career & Practice History
NPI enumerated June 28, 2007.
No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to November 2026.
NPI Administrative Meta
Other Physician Assistants in Port Washington
Mailing Address
1777 W Grand Ave
Port Washington, WI 530742077
Phone: 2622843456