NPIMap

Individual provider Active NPI

Cheryl Beth Hickethier, M.D., M.P.H.

  • Family Medicine Physician
  • Newport, OR
National Provider Identifier
1659322923
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD15365 Issued in OR
Practice address
36 SW Nye St
Newport, OR 97365-3821
Phone
(541) 265-4947
Fax
(541) 574-6252
NPI assigned
May 12, 2006
Last updated
May 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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 MD15365 OR Primary

Addresses

Primary practice location

36 SW Nye St
Newport, OR 97365-3821

Mailing address

36 SW Nye St
Newport, OR 97365-3821
Phone (541) 265-4947

Other practice location 1

525 N Bay St
Waldport, OR 97394-9010
Phone (541) 265-4947

Other practice location 2

4422 NE Devils Lake Blvd Ste 2
Lincoln City, OR 97367-5000
Phone (541) 265-4947

Other identifiers 2

IdentifierTypeStateIssuer
043617MedicaidOR
825072000OtherORBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100727000963 OR Practitioner - Family PracticePractitioner - General PracticePractitioner - Preventive Medicine 5294716783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice, Preventive Medicine
Education
Loma Linda University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of LincolnGroup PAC ID 3375439862, 28 clinicians

Practice addresses (Care Compare)

36 SW Nye St
Newport, OR 97365-3821
Phone (541) 265-4947

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.23
Promoting interoperability
100
Improvement activities
40
Cost
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15365ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Lincoln CurrentSince Mar 5, 2018 Accepting new patients
County of Lincoln CurrentSince Mar 5, 2018 Accepting new patients
County of Lincoln Past Accepting new patients
Mt. Tabor Family Medical Group, P.C. Past Accepting new patients
County of Lincoln Past Accepting new patients

Locations

1105 SE Jetty Ave
Ste C
Lincoln City, OR 97367
Phone (503) 965-6555

3780 SE Spy Glass Ridge Dr
Lincoln City, OR 97367
Phone (541) 265-0474

4422 NE Devils Lake Blvd
Ste 2
Lincoln City, OR 97367
Phone (541) 265-4196

1010 SW Coast Hwy
Newport, OR 97365
Phone (541) 265-0445

1010 SW Coast Hwy
Ste 203
Newport, OR 97365
Phone (541) 265-0445

322 NE Eads St
Newport, OR 97365
Phone (541) 265-0472

36 SW Nye St
Newport, OR 97365
Phone (541) 265-0445

1800 NE Sturdevant Rd
Toledo, OR 97391
Phone (541) 265-0445

525 N Bay St
Waldport, OR 97394
Phone (541) 265-4947

Interoperability endpoints

  • Direct secure messaging: chickethier228534@direct.ochin.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1659322923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 SW NYE ST",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973653821",
            "telephone_number": "541-265-4947",
            "fax_number": "541-574-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 SW NYE ST",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973653821",
            "telephone_number": "541-265-4947",
            "fax_number": "541-574-6252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 N Bay St",
            "address_purpose": "LOCATION",
            "city": "Waldport",
            "state": "OR",
            "postal_code": "973949010",
            "country_code": "US",
            "telephone_number": "541-265-4947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4422 NE Devils Lake Blvd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Lincoln City",
            "state": "OR",
            "postal_code": "973675000",
            "country_code": "US",
            "telephone_number": "541-265-4947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKETHIER",
        "first_name": "CHERYL",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD15365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043617",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "825072000",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, OR

Sources for this page

Verify at the official NPI Registry.