Individual provider Active NPI

Osman A. Hicklin III, M.D.

  • Diagnostic Radiology Physician
  • Seneca, SC
National Provider Identifier
1235196155
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
15030 Issued in SC
Practice address
1059 By Pass 123
Seneca, SC 29678-4762
Phone
(864) 885-0551
Fax
(864) 885-1822
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 15030 SC Primary
Diagnostic Radiology Physician 2085R0202X 53540 GA

Addresses

Primary practice location

1059 By Pass 123
Seneca, SC 29678-4762

Mailing address

1059 By Pass 123
Seneca, SC 29678-4762
Phone (864) 885-0551

Other identifiers 1

IdentifierTypeStateIssuer
GP2588MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100924000554 SC Practitioner - Diagnostic Radiology 5991835498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of South Carolina School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HHD Enterprises LLCGroup PAC ID 2365572864, 3 clinicians

Practice addresses (Care Compare)

1059 By Pass
Suite 123
Seneca, SC 29678-4762
Phone (864) 885-0551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15030SCMDClinical Social Worker
53540GAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HHD Enterprises, LLC Diagnostic Radiology CurrentSince Aug 10, 1999 Accepting new patients

Locations

1059 Highway 123
Seneca, SC 29678
Phone (864) 885-0551

Organizations & group practices 1

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1235196155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1059 BY PASS 123",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296784762",
            "telephone_number": "864-885-0551",
            "fax_number": "864-885-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 BY PASS 123",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296784762",
            "telephone_number": "864-885-0551",
            "fax_number": "864-885-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKLIN",
        "first_name": "OSMAN",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "15030",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "53540",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2588",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.