Individual provider Active NPI

Andrew G Hicks, PA

  • Medical Physician Assistant
  • Peoria, AZ
National Provider Identifier
1154757995
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5511 Issued in AZ
Practice address
7767 W Deer Valley Rd
Peoria, AZ 85382-2103
Phone
(623) 487-3003
Fax
(623) 889-0971
NPI assigned
Sep 25, 2013
Last updated
Sep 25, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5511 AZ Primary

Addresses

Primary practice location

7767 W Deer Valley Rd
Peoria, AZ 85382-2103

Mailing address

7767 W Deer Valley Rd
Peoria, AZ 85382-2103
Phone (623) 487-3003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20131114001109 AZ Practitioner - Physician Assistant 2466688759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Dermatology of Arizona PCGroup PAC ID 0547561169, 14 clinicians

Practice addresses (Care Compare)

740 E Highland Ave
Suite 101
Phoenix, AZ 85014-3609
Phone (602) 264-9044

8817 E Bell Rd
Suite 101
Scottsdale, AZ 85260-1589
Phone (602) 264-9044

Merit-based Incentive Payment System (MIPS)

Final score
89.99 of 100Reported as group
Quality
96.86
Improvement activities
40
Cost
70.83

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Scottsdale Dermatology, LTD Current Accepting new patients
Southwest Skin Specialists LLC Past Accepting new patients
Bill H. Halmi MD, PC Past Accepting new patients

Locations

3302 N Miller Rd
Ste D
Scottsdale, AZ 85251
Phone (480) 945-6356

8817 E Bell Rd
Ste 101
Scottsdale, AZ 85260
Phone (480) 513-9440

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1154757995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7767 W DEER VALLEY RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822103",
            "telephone_number": "623-487-3003",
            "fax_number": "623-889-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7767 W DEER VALLEY RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822103",
            "telephone_number": "623-487-3003",
            "fax_number": "623-889-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "ANDREW",
        "middle_name": "G",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-25",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "5511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.