DR. SCOTT ANDREW HACKETT (MD) – Plastic Surgery within the Head & Neck (Otolaryngology) Physician, NPI 1396703203
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. SCOTT ANDREW HACKETT (MD)
Andrew Jacobs Jr. Post Office, 125, West South Street, Old Southside, Indianapolis, Marion County, Indiana, 46206, United States
INDIANAPOLIS, IN 462066069
Phone: (317) 844-5656
Fax: (317) 575-3795
Type: Mailing
12065, Old Meridian Street, Carmel, Hamilton County, Indiana, 46032, United States
SUITE 205
CARMEL, IN 46032
Phone: (317) 844-5656
Fax: (317) 575-3795
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-10-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20101012001096 | I | Otolaryngology | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46206)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OTOLARYNGOLOGY | IN | 95004 | Injection of allergenic extracts into skin, accessed through the skin | 480 | 12 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| - | IL |
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