Active NPI
Jason Hicks, PA
- Physician Assistant
- Waconia, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9243
- Practice address
- 500 S Maple St
Waconia, MN 55387-1752 - Phone
- (952) 442-2191
- NPI assigned
- Jun 6, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9243 | MN | Primary |
Addresses
Primary practice location
500 S Maple St
Waconia, MN 55387-1752
Mailing address
PO Box 81
Chaska, MN 55318-0081
Phone (888) 398-3327
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36D52HI | Other | BCBS | |
| HP36290 | Other | HEALTH PARTNERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
500 S Maple St
Waconia, MN 55387-1752
Phone (952) 442-2191
7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone (952) 934-0570
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minnesota Valley Health Center Inc | Current | Accepting new patients | |
| Ridgeview Medical Center | Current | Accepting new patients | |
| Ridgeview Medical Center | Current | Accepting new patients | |
| Sibley Medical Center | Current | Accepting new patients | |
| Emergency Physicians & Consultants, PA | Past | Accepting new patients |
Locations
601 W Chandler St
Arlington, MN 55307
Phone (507) 964-2271
7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570
111 Hundertmark Rd
Ste 120
Chaska, MN 55318
Phone (952) 856-4001
621 S 4th St
Le Sueur, MN 56058
Phone (507) 665-3375
4695 Shoreline Dr
Spring Park, MN 55384
Phone (952) 442-7890
500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191
560 S Maple St
Ste 220
Waconia, MN 55387
Phone (952) 442-8011
Organizations & group practices 6
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.
-
- Certified Registered Nurse Anesthetist
- Waconia, MN
- NPI 1528364429
-
- Critical Access Hospital
- Le Sueur, MN
- NPI 1730248907
-
- Critical Access Hospital
- Arlington, MN
- NPI 1740240225
-
- General Acute Care Hospital
- Chaska, MN
- NPI 1710748538
-
- Diagnostic Radiology Physician
- Waconia, MN
- NPI 1811174923
-
- Emergency Medicine Physician
- Waconia, MN
- NPI 1194760009
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Le Sueur, MN
- NPI 1730248907
-
- General Acute Care Hospital
- Waconia, MN
- NPI 1275608457
-
- General Acute Care Hospital
- Chaska, MN
- NPI 1710748538
-
- Critical Access Hospital
- Arlington, MN
- NPI 1740240225
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196726400000",
"number": "1306885033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 81",
"city": "CHASKA",
"state": "MN",
"postal_code": "553180081",
"telephone_number": "888-398-3327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S MAPLE ST",
"city": "WACONIA",
"state": "MN",
"postal_code": "553871752",
"telephone_number": "952-442-2191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "JASON",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2007-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "9243",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "36D52HI",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP36290",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waconia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.