Individual provider Active NPI

Maria Isabel Hicks, M.D.

  • Dermatology Physician
  • Zephyrhills, FL
National Provider Identifier
1033376371
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME 110766 Issued in FL
Practice address
38051 Market Square Dr
Zephyrhills, FL 33542-7504
Phone
(813) 780-8085
Fax
(813) 355-5042
NPI assigned
May 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME 110766 FL Primary

Addresses

Primary practice location

38051 Market Square Dr
Zephyrhills, FL 33542-7504

Mailing address

38135 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (352) 567-0188

Other practice location 1

2352 Bruce B Downs Blvd Ste 202
Wesley Chapel, FL 33544-9203
Phone (813) 780-8085

Other identifiers 5

IdentifierTypeStateIssuer
592235385OtherFLUNITED HC
14FH0OtherFLFL BLUE
9898744OtherFLAETNA
004051900MedicaidFL
8504884OtherFLCIGNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address derm@flmed.directbygreenway.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20111017000481 FL Practitioner - DermatologyPractitioner - Orthopedic Surgery 9436321486 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians

Practice addresses (Care Compare)

38051 Market Square Dr
Suite 123
Zephyrhills, FL 33542-7504
Phone (813) 780-8085

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions503
Removal or shaving of skin growth1-10
Skin biopsy165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 110766FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohi West Medical Group II LLC CurrentSince May 1, 2024 Accepting new patients
Florida Medical Clinic, LLC CurrentSince Aug 1, 2023 Accepting new patients
Ohi West Medical Group II LLC CurrentSince May 1, 2024 Accepting new patients
Florida Medical Clinic LLC CurrentSince Aug 1, 2023 Accepting new patients
Ohi West Medical Group II LLC Past Accepting new patients

Locations

38051 Market Square Dr
Zephyrhills, FL 33542
Phone (813) 779-2057

38051 Market Square Dr
#123
Zephyrhills, FL 33542

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651

38051 Market Square Dr
Ste 123
Zephyrhills, FL 33542
Phone (813) 780-8085

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1033376371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQUARE DR",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "352-567-0188",
            "fax_number": "813-355-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38051 MARKET SQUARE DR",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427504",
            "telephone_number": "813-780-8085",
            "fax_number": "813-355-5042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2352 Bruce B Downs Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335449203",
            "country_code": "US",
            "telephone_number": "813-780-8085",
            "fax_number": "813-355-5042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "MARIA",
        "middle_name": "ISABEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME 110766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HC",
            "identifier": "592235385",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE",
            "identifier": "14FH0",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9898744",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004051900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8504884",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "derm@flmed.directbygreenway.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "38051 Market Square Dr",
            "city": "Zephyrhills",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335427504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.