Individual provider Active NPI

Melinda Lee Hicks, O.D.

  • Optometrist
  • Grand Junction, CO
National Provider Identifier
1154493500
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1453 Issued in CO
Practice address
2737 Crossroads Blvd
Grand Junction, CO 81506-3954
Phone
(970) 243-9681
Fax
(970) 243-9155
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1453 CO Primary

Addresses

Primary practice location

2737 Crossroads Blvd
Grand Junction, CO 81506-3954

Mailing address

2737 Crossroads Blvd
Grand Junction, CO 81506-3954
Phone (970) 243-9681

Other identifiers 3

IdentifierTypeStateIssuer
08145302MedicaidCO
410046449OtherCOMETRA-HEALTH RR MDCR
4285550001OtherCODMERC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100805000634 CO Practitioner - Optometry 8325171713 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Melinda L Hicks, O.D., P.C. Optometrist CurrentSince Jan 1, 2002 Accepting new patients
Hicks Eye Care, PC Optometrist Current Accepting new patients

Locations

2737 Crossroads Blvd
Grand Junction, CO 81506
Phone (970) 243-3061

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1154493500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2737 CROSSROADS BLVD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815063954",
            "telephone_number": "970-243-9681",
            "fax_number": "970-243-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 CROSSROADS BLVD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815063954",
            "telephone_number": "970-243-9681",
            "fax_number": "970-243-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "MELINDA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08145302",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "METRA-HEALTH RR MDCR",
            "identifier": "410046449",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4285550001",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.