Timothy David Hicks, M.D.

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

A157165 Issued in CA

Practice address

1201 W la Veta Ave
Orange, CA 92868-4203

Phone

(887) 702-4628

Fax

(855) 246-2329

NPI assigned

Mar 23, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• UC Regents Uci Dept of Pediatrics

  • Pediatrics Physician
  • Orange, CA
  • NPI 1235187311
  Medicare reassignment NPD
• University of California Irvine

  • Federally Qualified Health Center (FQHC)
  • Anaheim, CA
  • NPI 1598790529
  Medicare reassignment NPD
• UC Irvine Health Cancer Center, Newport Pacific Medical Center

  • Infusion Therapy Clinic/Center
  • Costa Mesa, CA
  • NPI 1558783696
  NPD
• University of California Irvine

  • Pharmacy
  • Irvine, CA
  • NPI 1669344339
  NPD
• Pediatric Subspecialty Faculty, Inc.

  • Pediatrics Physician
  • Orange, CA
  • NPI 1790850279
  NPD (past)
• University of California Irvine

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  NPD (past)

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1386006823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "887-702-4628",
            "fax_number": "855-246-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "887-702-4628",
            "fax_number": "855-246-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "TIMOTHY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "CA",
            "license": "A157165",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A157165",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "PingMD",
            "affiliation": "N",
            "address_1": "505 S Main St Ste 525",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928684553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Catherine Grace Heyrosa, RN, CDCES
• Frederick Stanley III Hickman
• Anna Hicks
• David A. Hicks, M.D.
• Rebecca Ann Hicks, M.D.
• Vanessa Michelle Hicks
• Cecelia Michelle Hidalgo, MD
• Elizabeth Hidalgo
• Elsie Rosso Hidalgo, MD
• Patricia Brislette Hidalgo

• Pediatric Pulmonology Physician in Orange, CA
• Providers in Orange, CA by specialty
• Pediatric Pulmonology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.