Jacob Wayne Hickson

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

RN1036244 Issued in DC

Practice address

2112 New Hampshire Ave NW Apt 1007
Washington, DC 20009-6530

Phone

(601) 422-9537

NPI assigned

Mar 26, 2021

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

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medstar Georgetown University Hospital Hospital, Washington, DC, CCN 090004

Merit-based Incentive Payment System (MIPS)

Final score

82.34 of 100Reported as group

Quality

67.9

Promoting interoperability

100

Improvement activities

40

Cost

69.47

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187

  DC

  Medicare reassignment Care Compare group NPD
• Medstar Medical Group II LLC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1376887844
  NPD

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

• Medstar - Georgetown Medical Center, Inc.

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1427145176
  Care Compare affiliation

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1609453497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 NEW HAMPSHIRE AVE NW APT 1007",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200096530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 NEW HAMPSHIRE AVE NW APT 1007",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200096530",
            "telephone_number": "601-422-9537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Reservoir Rd NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200072113",
            "country_code": "US",
            "telephone_number": "601-422-9537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKSON",
        "first_name": "JACOB",
        "middle_name": "WAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "DC",
            "license": "RN1036244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pernell Hicks
• Raiesha Amyela Hicks, CRT, HHA
• Sarita Lynette Hicks
• Temika Hicks
• Debra Hickson
• Joniesha Hickson, PSY.D.
• Adam G Hidad, BS
• Christian Ricardo Hidalgo Jara
• Kelsey Rebecca Hidalgo Mulgrew
• Timothy Hider, PEER SUPPORT

• Acute Care Nurse Practitioner in Washington, DC
• Providers in Washington, DC by specialty
• Acute Care Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.