Active NPI
Ricardo Hickinson, OD
- Optometrist
- Southfield, MI
National Provider Identifier
1205976271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901003681
- Practice address
- 19800 W 8 Mile Rd
Southfield, MI 48075-5730 - Phone
- (248) 352-6900
- Fax
- (248) 354-0345
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901003681 | MI | Primary |
Addresses
Primary practice location
19800 W 8 Mile Rd
Southfield, MI 48075-5730
Mailing address
19800 W 8 Mile Rd
Southfield, MI 48075-5730
Phone (248) 352-6900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901003681 | MI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205976271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19800 W 8 MILE RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480755730",
"telephone_number": "248-352-6900",
"fax_number": "248-354-0345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19800 W 8 MILE RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480755730",
"telephone_number": "248-352-6900",
"fax_number": "248-354-0345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKINSON",
"first_name": "RICARDO",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901003681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.