Individual provider Active NPI

Rachael Ann Hickman, PA-C

  • Physician Assistant
  • La Place, LA
National Provider Identifier
1437892353
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
332712 Issued in LA
Practice address
1900 W Airline Hwy
La Place, LA 70068-3338
Phone
(985) 652-7000
NPI assigned
Apr 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 332712 LA Primary

Addresses

Primary practice location

1900 W Airline Hwy
La Place, LA 70068-3338

Mailing address

29 Waverly PL
Metairie, LA 70003-2553
Phone (504) 421-4435

Other practice location 1

200 W Esplanade Ave
Kenner, LA 70065-2489
Phone (504) 464-8506

Other practice location 2

1057 Paul Maillard Rd
Luling, LA 70070-4349
Phone (985) 785-3740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20221006000394 LA Practitioner - Physician Assistant 9739565276 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Douglas Mehaffie MD LLCGroup PAC ID 7012048697, 18 clinicians
Center for Restorative Breast Surgery LLCGroup PAC ID 8628980729, 17 clinicians

Practice addresses (Care Compare)

148 Wall Blvd
Gretna, LA 70056-7107
Phone (504) 393-2273

1717 Saint Charles Ave
New Orleans, LA 70130-5223
Phone (504) 899-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 2

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": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1437892353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 WAVERLY PL",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700032553",
            "telephone_number": "504-421-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W AIRLINE HWY",
            "city": "LA PLACE",
            "state": "LA",
            "postal_code": "700683338",
            "telephone_number": "985-652-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Esplanade Ave",
            "address_purpose": "LOCATION",
            "city": "Kenner",
            "state": "LA",
            "postal_code": "700652489",
            "country_code": "US",
            "telephone_number": "504-464-8506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1057 Paul Maillard Rd",
            "address_purpose": "LOCATION",
            "city": "Luling",
            "state": "LA",
            "postal_code": "700704349",
            "country_code": "US",
            "telephone_number": "985-785-3740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "RACHAEL",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "332712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Place, LA

Sources for this page

Verify at the official NPI Registry.