Individual provider Active NPI

Thomas V Hicks, PH.D., L.P.

  • Psychologist
  • Bloomington, MN
National Provider Identifier
1275589269
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP 4530 Issued in MN
Practice address
900 American Blvd E
Suite 201
Bloomington, MN 55420-1392
Phone
(952) 854-2622
Fax
(952) 854-3293
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP 4530 MN Primary

Addresses

Primary practice location

900 American Blvd E
Suite 201
Bloomington, MN 55420-1392

Mailing address

900 American Blvd E
Suite 201
Bloomington, MN 55420-1392
Phone (952) 854-2622

Other identifiers 3

IdentifierTypeStateIssuer
112341OtherMNHEALTHPARTNERS PROVIDER #
61-94690OtherMNMEDICA PROVIDER NUMBER
057G8HIOtherMNBC/BS PROVIDER NUMBER

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 14, 2008 through Oct 14, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP 4530MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sara J. W. Biebl, PH.D., Licensed Psychologist, PLLC Past Accepting new patients

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1275589269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 AMERICAN BLVD E",
            "address_2": "SUITE 201",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554201392",
            "telephone_number": "952-854-2622",
            "fax_number": "952-854-3293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 AMERICAN BLVD E",
            "address_2": "SUITE 201",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554201392",
            "telephone_number": "952-854-2622",
            "fax_number": "952-854-3293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "THOMAS",
        "middle_name": "V",
        "credential": "PH.D., L.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP 4530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS PROVIDER #",
            "identifier": "112341",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PROVIDER NUMBER",
            "identifier": "61-94690",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER NUMBER",
            "identifier": "057G8HI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.