NPIMap

Individual provider Active NPI

Steven L. Hickerson, M.D.

  • Infectious Disease Physician
  • Tyler, TX
National Provider Identifier
1376543546
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
H6286 Issued in TX
Practice address
935 S Baxter Ave
Ste 103
Tyler, TX 75701-2245
Phone
(903) 592-4473
Fax
(903) 592-4474
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X H6286 TX Primary

Addresses

Primary practice location

935 S Baxter Ave
Ste 103
Tyler, TX 75701-2245

Mailing address

PO Box 131629
Tyler, TX 75713-1629
Phone (903) 592-4473

Other identifiers 1

IdentifierTypeStateIssuer
133135708MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041110000069 TX Practitioner - Infectious DiseasePractitioner - Internal Medicine 5496718504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Texas Tech University Health Science Center School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Special Health Resources for Texas, IncorporatedGroup PAC ID 1355326158, shared by 11 NPIs, 14 clinicians
East Texas Infectious Disease Consultants, PLLCGroup PAC ID 7911001375, 5 clinicians

Practice addresses (Care Compare)

1300 Clinic Dr
Tyler, TX 75701-2119
Phone (903) 597-7558

935 S Baxter Ave
Suite 103
Tyler, TX 75701-2245
Phone (903) 592-4473

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.03 of 100Reported as individual
Quality
88.12
Promoting interoperability
100
Improvement activities
40
Cost
77.69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H6286TXMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Texas Infectious Disease Consultants, PLLC Infectious Disease CurrentSince Jun 1, 2003 Accepting new patients
Special Health Resources for Texas, Incorporated Past Accepting new patients
Special Health Resources for Texas, Incorporated Past Accepting new patients
University of Texas Health Science Center at Tyler-Facility-Physician PastSince Jun 1, 2003 Accepting new patients

Locations

935 S Baxter Ave
Ste 103
Tyler, TX 75701
Phone (903) 592-4473

Interoperability endpoints

  • Direct secure messaging: shickerson6224@christushealth.direct-ci.net
  • Direct secure messaging: shickerson355479@ahs.direct-ci.com
  • Direct secure messaging: steven.hickerson@wchcl.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1376543546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 131629",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757131629",
            "telephone_number": "903-592-4473",
            "fax_number": "903-592-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 S BAXTER AVE",
            "address_2": "STE 103",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012245",
            "telephone_number": "903-592-4473",
            "fax_number": "903-592-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKERSON",
        "first_name": "STEVEN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "H6286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133135708",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.