Individual provider Active NPI

Veronica Marie Hicks, PA-C

  • Physician Assistant
  • Renton, WA
National Provider Identifier
1629089396
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004943 Issued in WA
Practice address
1205 N 10TH St Ste a
Renton, WA 98057-5577
Phone
(425) 690-3474
Fax
(425) 690-9475
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10004943 WA
Physician Assistant 363A00000X PA10004943 WA Primary

Addresses

Primary practice location

1205 N 10TH St Ste a
Renton, WA 98057-5577

Mailing address

1129 23Rd Ave S Apt 202
Seattle, WA 98144-2961
Phone (206) 328-4438

Other practice location 1

1151 Denny Way
Seattle, WA 98109-5326
Phone (206) 682-7418

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20060308000816 WA Practitioner - Physician Assistant 1355358805 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

1205 N 10TH St
Suite a
Renton, WA 98057-5577
Phone (425) 656-4211

16850 SE 272ND St
Covington, WA 98042-4931

26458 Maple Valley Black Diamond Rd
Maple Valley, WA 98038-8350
Phone (425) 656-5577

400 S 43Rd St
Renton, WA 98055-5714
Phone (425) 228-3450

Hospital & facility affiliations

  • Valley Medical Center Hospital, Renton, WA, CCN 500088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10004943WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 27, 2015 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 27, 2015 Accepting new patients
U.S. Healthworks Medical Group of Washington, PS Past Accepting new patients

Locations

1007 39th Ave SE
Puyallup, WA 98374
Phone (253) 435-3100

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: vhicks101908@direct.valleymed.org

Organizations & group practices 5

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 2

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1629089396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 23RD AVE S APT 202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442961",
            "telephone_number": "206-328-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 N 10TH ST STE A",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575577",
            "telephone_number": "425-690-3474",
            "fax_number": "425-690-9475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1151 Denny Way",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981095326",
            "country_code": "US",
            "telephone_number": "206-682-7418",
            "fax_number": "206-623-0884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "VERONICA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10004943",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1007 39th Ave SE",
            "city": "Puyallup",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983742192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.