Individual provider Active NPI

Andrew James Hickman, OD

  • Optometrist
  • Russellville, AR
National Provider Identifier
1407342371
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2781 Issued in AR
Practice address
2711 E Parkway Drive
Russellville, AR 72801
Phone
(479) 968-7302
Fax
(479) 968-5131
NPI assigned
Jul 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2781 AR Primary

Addresses

Primary practice location

2711 E Parkway Drive
Russellville, AR 72801

Mailing address

2711 E Parkway Drive
Russellville, AR 72801
Phone (479) 968-7302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180802001334 AR Practitioner - Optometry 1658629936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boozman-Hof Regional Eye Clinic PAGroup PAC ID 4981628245, 12 clinicians

Practice addresses (Care Compare)

3737 W Walnut St
Rogers, AR 72756-1839
Phone (479) 246-1700

Merit-based Incentive Payment System (MIPS)

Final score
92.75 of 100Reported as group
Quality
99.17
Improvement activities
40
Cost
76.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Boozman-Hof Regional Eye Clinic PA Optometrist CurrentSince Aug 1, 2020 Accepting new patients
Boozman-Hof Regional Eye Clinic Optometrist Past Accepting new patients
Boozman-Hof Regional Eye Clinic PA Past Accepting new patients

Locations

25 Cunningham Cor
Bella Vista, AR 72714
Phone (479) 246-1700

3737 W Walnut St
Rogers, AR 72756
Phone (479) 246-1700

Interoperability endpoints

  • Direct secure messaging: ahickman@bhrec.intellechartdirect.net

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": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1407342371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 E PARKWAY DRIVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72801",
            "telephone_number": "479-968-7302",
            "fax_number": "479-968-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 E PARKWAY DRIVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72801",
            "telephone_number": "479-968-7302",
            "fax_number": "479-968-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.