Individual provider Active NPI

Derrick Gerard Hickey, MD

  • Orthopaedic Hand Surgery Physician
  • Wrightsville Beach, NC
National Provider Identifier
1356376289
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
200201100 Issued in NC
Practice address
206 Causeway Dr Unit 232
Wrightsville Beach, NC 28480-1759
Phone
(910) 791-4492
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 200201100 NC Primary
Orthopaedic Surgery Physician 207X00000X 200201100 NC

Addresses

Primary practice location

206 Causeway Dr Unit 232
Wrightsville Beach, NC 28480-1759

Mailing address

6101 Old Branch Rd
C/O D. Hickey, President, Port City Orthopaedics PLLC
Wilmington, NC 28409
Phone (910) 791-4492

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061121000139 NC Practitioner - Orthopedic SurgeryPractitioner - Hand Surgery 6204834583 Reassigns benefits to 1 organization
I20211229001523 PA Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 6204834583 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200201100NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. Orthopaedic Surgery CurrentSince Nov 2, 2021 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients

Locations

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: dhickey170094@direct-guthrie.org

Organizations & group practices 3

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1356376289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 OLD BRANCH RD",
            "address_2": "C/O D. HICKEY, PRESIDENT, PORT CITY ORTHOPAEDICS PLLC",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28409",
            "telephone_number": "910-791-4492",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 CAUSEWAY DR UNIT 232",
            "city": "WRIGHTSVILLE BEACH",
            "state": "NC",
            "postal_code": "284801759",
            "telephone_number": "910-791-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKEY",
        "first_name": "DERRICK",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "NC",
            "license": "200201100",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "200201100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wrightsville Beach, NC

Sources for this page

Verify at the official NPI Registry.