Individual provider Active NPI

Thomas Stephen Fickett

  • Anesthesiologist Assistant
  • Tallahassee, FL
National Provider Identifier
1124751011
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA759 Issued in FL
Practice address
2173 Centerville PL Ste a
Tallahassee, FL 32308-8303
Phone
(850) 385-0144
NPI assigned
Jul 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA759 FL Primary

Addresses

Primary practice location

2173 Centerville PL Ste a
Tallahassee, FL 32308-8303

Mailing address

1894 Merchants Row Blvd Apt 626
Tallahassee, FL 32311-8875
Phone (850) 728-4765

Other practice location 1

339 Consort Dr
Ballwin, MO 63011-4439
Phone (636) 386-9224

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221028001855 FL Practitioner - Anesthesiology Assistant 5698151819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology Associates of Tallahassee IncGroup PAC ID 3476446014, 133 clinicians

Practice addresses (Care Compare)

2629 Welaunee Blvd
Tallahassee, FL 32308-4697
Phone (954) 939-5000

Hospital & facility affiliations

  • Tallahassee Memorial Healthcare Hospital, Tallahassee, FL, CCN 100135
  • HCA Florida Capital Hospital Hospital, Tallahassee, FL, CCN 100254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Associates of Tallahassee Inc CurrentSince Oct 19, 2022 Accepting new patients
Anesthesiology Associates of Tallahassee Inc CurrentSince Oct 19, 2022 Accepting new patients
Anesthesiology Associates of Tallahassee Inc PastSince Nov 10, 2024 Accepting new patients

Locations

333 N Byron Butler Pkwy
Perry, FL 32347
Phone (850) 584-0643

3334 Capital Medical Blvd
Ste 500
Tallahassee, FL 32308
Phone (850) 877-4688

2173 Centerville Pl
Ste A
Tallahassee, FL 32308

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

2629 Welaunee Blvd
Tallahassee, FL 32308
Phone (850) 877-4688

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1124751011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1894 MERCHANTS ROW BLVD APT 626",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323118875",
            "telephone_number": "850-728-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2173 CENTERVILLE PL STE A",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323088303",
            "telephone_number": "850-385-0144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "339 Consort Dr",
            "address_purpose": "LOCATION",
            "city": "Ballwin",
            "state": "MO",
            "postal_code": "630114439",
            "country_code": "US",
            "telephone_number": "636-386-9224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FICKETT",
        "first_name": "THOMAS",
        "middle_name": "STEPHEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-07",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.