Stephanie L Hicks, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9118138 Issued in FL

Practice address

132 Goldenrod Dr
Saint Augustine, FL 32092-7665

Phone

(815) 342-4901

NPI assigned

Jan 14, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Health Service Systems, Inc

  • Internal Medicine Physician
  • New Lenox, IL
  • NPI 1851323257
  Medicare reassignment NPD
• Advanced Midwest Radiology S C

  • Diagnostic Radiology Physician
  • New Lenox, IL
  • NPI 1013965326
  Medicare reassignment
• Aurora Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Yorkville, IL
  • NPI 1407379423
  Medicare reassignment
• Dr. Susan Rife Family Medicine SC

  • Family Medicine Physician
  • Orland Park, IL
  • NPI 1184602880
  Medicare reassignment
• Aurora Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Aurora, IL
  • NPI 1508389628
  NPD
• Health Service Systems, Inc

  • Urgent Care Clinic/Center
  • Mokena, IL
  • NPI 1578235800
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708819200000",
    "number": "1366808735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 GOLDENROD DR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320927665",
            "telephone_number": "153-424-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 GOLDENROD DR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320927665",
            "telephone_number": "815-342-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2024-02-25",
        "certification_date": "2024-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.005757",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abla Herzalla
• Kathryn Ruth Hessi, M.S. CCC-SLP
• Cameron Heustis
• Maryann Hickey, RN, APN
• Samantha Jayne Hickey, LMHC
• High Power Diagnosis
• Amanda Hill, APRN-C
• Felicia Hill
• Seletha Hill
• Julia Hilton, MA, RMHCI

• Physician Assistant in Saint Augustine, FL
• Providers in Saint Augustine, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.