Individual provider Active NPI

Daniel D Hickman, M.D.

  • Family Medicine Physician
  • Pace, FL
National Provider Identifier
1487608113
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME76070 Issued in FL
Practice address
3754 Highway 90
Suite 200
Pace, FL 32571-1020
Phone
(850) 416-5200
Fax
(850) 416-5201
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME76070 FL Primary

Addresses

Primary practice location

3754 Highway 90
Suite 200
Pace, FL 32571-1020

Mailing address

PO Box 2699
Pensacola, FL 32513-2699

Other identifiers 1

IdentifierTypeStateIssuer
254249800MedicaidFL

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20090217000727 FL Practitioner - Family Practice 2567527088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New Mexico School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

3754 Hwy 90
Pace, FL 32571-1098

4501 N Davis Hwy
Suite a
Pensacola, FL 32504-2724
Phone (850) 476-9000

4501 N Davis Hwy
Suite C
Pensacola, FL 32503-2724
Phone (850) 416-4960

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions16
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System Inc CurrentSince Sep 1, 1996 Accepting new patients
Sacred Heart Health System, Inc. Family Medicine CurrentSince Sep 1, 1996 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients

Locations

3754 Highway 90
Ste 200
Pace, FL 32571
Phone (850) 416-5200

4435 Highway 90
Pace, FL 32571
Phone (850) 304-0390

5045 Carpenter Creek Dr
Pensacola, FL 32503
Phone (850) 416-2400

4501 N Davis Hwy
Ste A
Pensacola, FL 32503
Phone (850) 476-9000

Interoperability endpoints

  • Direct secure messaging: daniel.hickman.1@9582.direct.athenahealth.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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1487608113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3754 HIGHWAY 90",
            "address_2": "SUITE 200",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325711020",
            "telephone_number": "850-416-5200",
            "fax_number": "850-416-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "DANIEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME76070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254249800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pace, FL

Sources for this page

Verify at the official NPI Registry.