Individual provider Active NPI

Ilze Hicks, M.D.

  • General Practice Physician
  • New Smyrna Beach, FL
National Provider Identifier
1619337532
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME124762 Issued in FL
Practice address
PO Box 1268
New Smyrna Beach, FL 32170-1268
Phone
(386) 259-8803
Fax
(386) 213-9981
NPI assigned
Mar 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X ME124762 FL
General Practice Physician 208D00000X ME124762 FL Primary

Addresses

Primary practice location

PO Box 1268
New Smyrna Beach, FL 32170-1268

Mailing address

PO Box 1268
New Smyrna Beach, FL 32170-1268
Phone (386) 259-8803

Other identifiers 1

IdentifierTypeStateIssuer
112624200MedicaidFL

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
I20160405001743 FL Practitioner - General Practice 4385941475 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Whatever It Takes Medical LLCGroup PAC ID 9739535741, 3 clinicians

Practice addresses (Care Compare)

807 E 7TH Ave
New Smyrna Beach, FL 32169-3109
Phone (386) 259-8803

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME124762FLMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iah of Florida, LLC CurrentSince Mar 14, 2016 Accepting new patients
KND Development 59 LLC Current Accepting new patients
Rmed LLC General Practice CurrentSince Mar 14, 2016 Accepting new patients
KND Development 59, LLC CurrentSince Dec 14, 2019 Accepting new patients
Rmed LLC CurrentSince Mar 14, 2016 Accepting new patients
Whatever It Takes Medical, LLC Pain Medicine CurrentSince Nov 1, 2023 Accepting new patients
KND Development 59, LLC CurrentSince Dec 14, 2019 Accepting new patients
Symphony Specialty Group, LLC PastSince Jul 17, 2023 Accepting new patients

Locations

801 Oak St
Green Cv Spgs, FL 32043
Phone (904) 215-7015

4348 Southpoint Blvd
Ste 100
Jacksonville, FL 32216
Phone (904) 281-1087

5011 Gate Pkwy
Bldg 100
Jacksonville, FL 32256
Phone (904) 512-7239

2600 Lake Lucien Dr
Ste 112
Maitland, FL 32751
Phone (321) 207-9029

3030 6th St S
St Petersburg, FL 33705
Phone (727) 894-8719

8600 Hidden River Pkwy
Ste 75
Tampa, FL 33637
Phone (813) 517-0137

Organizations & group practices 8

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": "1457049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1619337532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1268",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321701268",
            "telephone_number": "386-259-8803",
            "fax_number": "386-213-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 1268",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321701268",
            "telephone_number": "386-259-8803",
            "fax_number": "386-213-9981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "ILZE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-04",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME124762",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME124762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112624200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.