Patricia R Hickham, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

22278 Issued in LA

Practice address

4141 Bienville St Ste 108
New Orleans, LA 70119

Phone

(504) 962-7771

Fax

(504) 962-7776

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Dermatology

Education

Louisiana State University School of Medicine in New Orleans, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Hickham Dermatology and Med Spa LLC

  • Dermatology Physician
  • New Orleans, LA
  • NPI 1114435690
  Medicare reassignment Authorized official
• Dege

  • Pain Medicine (Anesthesiology) Physician
  • Metairie, LA
  • NPI 1588272215
  NPD

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528588800000",
    "number": "1073682084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 BIENVILLE ST STE 108",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701195149",
            "telephone_number": "504-962-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 BIENVILLE ST STE 108",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70119",
            "telephone_number": "504-962-7771",
            "fax_number": "504-962-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKHAM",
        "first_name": "PATRICIA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2018-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "22278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kierra Hickerson
• Michael Hickerson, MSW RSW
• Rozie' Hickerson, MPA
• Bryn Hickey, LPCC
• Hickham Dermatology and Med Spa LLC
• Tyler Hicklin
• Areana Hickman
• Dean A Hickman, MD
• Brandon Lee Hicks, MD
• Chelsea Hicks, PHARMD

• Dermatology Physician in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Dermatology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.