Individual provider Active NPI

Katherine Hicks, PA-C

  • Surgical Physician Assistant
  • Temple Terrace, FL
National Provider Identifier
1225791031
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9115110 Issued in FL
Practice address
5901 E Fowler Ave Ste 100
Temple Terrace, FL 33617-2305
Phone
(813) 978-9700
Fax
(813) 558-6185
NPI assigned
Oct 19, 2021
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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 PA9115110 FL Primary

Addresses

Primary practice location

5901 E Fowler Ave Ste 100
Temple Terrace, FL 33617-2305

Mailing address

5901 E Fowler Ave Ste 100
Temple Terrace, FL 33617-2305
Phone (813) 978-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211117003312 FL Practitioner - Physician Assistant 8921497660 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

119 Oakfield Dr
Brandon, FL 33511-5779
Phone (813) 681-5551

3334 Capital Medical Blvd
Suite 400
Tallahassee, FL 32308-4470
Phone (850) 877-8174

560 S Lakewood Dr
101 Florida Orthopaedic Institute
Brandon, FL 33511-5015
Phone (813) 978-9700

9320 US Hwy 301 S
Suite 160
Riverview, FL 33578-6300
Phone (913) 978-9700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9115110FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Musculoskeletal Institute Chartered CurrentSince Nov 29, 2021 Accepting new patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Dec 20, 2024 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Nov 29, 2021 Accepting new patients

Locations

560 S Lakewood Dr
Ste 101
Brandon, FL 33511
Phone (813) 558-6044

11286 Boyette Rd
Ste 101
Riverview, FL 33569

2605 Welaunee Blvd
Tallahassee, FL 32308
Phone (850) 219-1932

13020 N Telecom Pkwy
Temple Terrace, FL 33637

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

5901 E Fowler Ave
Ste 100
Temple Terrace, FL 33617
Phone (813) 987-9700

2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: katherine.hicks.1@18802.direct.athenahealth.com

Organizations & group practices 5

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": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1225791031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 E FOWLER AVE STE 100",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336172305",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 E FOWLER AVE STE 100",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336172305",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9115110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.