Individual provider Active NPI

Perrin Hickey, PA

  • Surgical Physician Assistant
  • Exeter, NH
National Provider Identifier
1093932667
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0772 Issued in NH
Practice address
7 Alumni Dr
Exeter, NH 03833-2118
Phone
(603) 778-7975
Fax
(603) 778-7964
NPI assigned
Apr 18, 2007
Last updated
Jul 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0772 NH Primary

Addresses

Primary practice location

7 Alumni Dr
Exeter, NH 03833-2118

Mailing address

7 Holland Way FL 1
Exeter, NH 03833-2997
Phone (603) 778-7975

Other identifiers 1

IdentifierTypeStateIssuer
3090823MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200908001712 NY Practitioner - Physician Assistant 3072693571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Community Medical, PCGroup PAC ID 0143238782, 153 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001978CTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Appledore Medical Group, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: phickey107477@direct.upstate.edu

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1093932667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 HOLLAND WAY FL 1",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332997",
            "telephone_number": "603-778-7975",
            "fax_number": "603-778-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ALUMNI DR",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332118",
            "telephone_number": "603-778-7975",
            "fax_number": "603-778-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKEY",
        "first_name": "PERRIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NH",
            "license": "0772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3090823",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, NH

Sources for this page

Verify at the official NPI Registry.