Ramiro Icaza, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MDR7D79 Issued in MO

Practice address

1008 N Main St
Sikeston, MO 63801

Phone

(573) 472-6001

Fax

(573) 472-6006

NPI assigned

Aug 31, 2006

Last updated

Aug 14, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Family Practice

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Big Springs Medical AssociationGroup PAC ID 6709871007, 53 clinicians

Alliance Health and Dermatology, LLCGroup PAC ID 5597094961, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ramiro.icaza.1@14422.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alliance Health and Dermatology, LLC

  • Clinic/Center
  • Cape Girardeau, MO
  • NPI 1952958449
  Medicare reassignment Care Compare group NPD
• Big Springs Medical Association

  dba Missouri Highlands Health Care

  • Federally Qualified Health Center (FQHC)
  • Van Buren, MO
  • NPI 1225045321
  Medicare reassignment Care Compare group NPD
• Missouri Delta Medical Center

  • Internal Medicine Physician
  • Sikeston, MO
  • NPI 1508967860

  Family Medicine

  Medicare reassignment NPD
• Pemiscot County Memorial Hospital

  • Emergency Care Clinic/Center
  • Hayti, MO
  • NPI 1578668661
  Medicare reassignment NPD
• Big Springs Medical Association

  dba Missouri Highlands Health Care

  • Federally Qualified Health Center (FQHC)
  • Poplar Bluff, MO
  • NPI 1972466233
  NPD
• Missouri Delta Medical Center

  dba Delta Regional Pharmacy

  • Community/Retail Pharmacy
  • Malden, MO
  • NPI 1578371621
  NPD
• Pemiscot County Memorial Hospital

  • Rural Acute Care Hospital
  • Hayti, MO
  • NPI 1437179710
  NPD
• Big Springs Medical Association

  dba Missouri Highlands Health Care

  • Federally Qualified Health Center (FQHC)
  • Poplar Bluff, MO
  • NPI 1295820348
  NPD (past)

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

• Southeast Hospital

  dba Mercy Hospital Southeast

  • General Acute Care Hospital
  • Cape Girardeau, MO
  • NPI 1811006661
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1457463960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 WEST INDEPENDENCE STREET",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "63755",
            "telephone_number": "573-243-0750",
            "fax_number": "813-891-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "63801",
            "telephone_number": "573-472-6001",
            "fax_number": "573-472-6006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 West Independence Street",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MO",
            "postal_code": "63755",
            "country_code": "US",
            "telephone_number": "573-243-0750",
            "fax_number": "573-243-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ICAZA",
        "first_name": "RAMIRO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "MDR7D79",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID KIES PERSONAL",
            "identifier": "000094200",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202995807",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Hummel, MA, PLPC
• Hunter Acres Caring Center Inc (Hunter Acres Caring Center)
• Colleen L Hunter-Pearson, MD
• Laurie Hutcheson, LMSW
• Tara Hux
• Razvan Iorga, M.D.
• Ipc Pac Healthcare Services of Missouri Inc
• Jami Lyn Irvan, LMT
• Angela Dawn Jackson, MA, CCC-SLP
• Dorothy Machelle Jackson

• Family Medicine Physician in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.