Individual provider Active NPI

Lindsay Hickerson, MD

  • Orthopaedic Trauma Physician
  • Melbourne, FL
National Provider Identifier
1679700959
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
ME140535 Issued in FL
Practice address
1350 Hickory St
Melbourne, FL 32901
Phone
(321) 434-1401
Fax
(321) 434-1667
NPI assigned
Jun 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Trauma Physician 207XX0801X 31400 OK
Orthopaedic Trauma Physician 207XX0801X 273286 NY
Orthopaedic Trauma Physician 207XX0801X ME140535 FL Primary

Addresses

Primary practice location

1350 Hickory St
Melbourne, FL 32901

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 434-1981

Other identifiers 3

IdentifierTypeStateIssuer
LD519OtherFLMEDICARE
102741400MedicaidFL
LD522OtherFLMEDICARE

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
I20190521000244 FL Practitioner - Orthopedic Surgery 1557509411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3300 S Fiske Blvd
Rockledge, FL 32955-4306

PO Box
Franklin, TN 37068

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.18 of 100Reported as apm
Quality
71.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME140535FLMDOrthopaedic Trauma Physician
273286NYMDOrthopaedic Trauma Physician
31400OKMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Key West Hma Physician Management LLC CurrentSince Feb 23, 2024 Accepting new patients
Key West Hma Physician Management, LLC CurrentSince Feb 23, 2024 Accepting new patients

Locations

1111 12th St
Ste 104
Key West, FL 33040
Phone (305) 293-1830

Interoperability endpoints

  • Direct secure messaging: lindsay.hickerson.1@4692.direct.athenahealth.com

Organizations & group practices 2

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 1

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": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1679700959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-434-1981",
            "fax_number": "321-951-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 HICKORY ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32901",
            "telephone_number": "321-434-1401",
            "fax_number": "321-434-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKERSON",
        "first_name": "LINDSAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "OK",
            "license": "31400",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "NY",
            "license": "273286",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "FL",
            "license": "ME140535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "LD519",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102741400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "LD522",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.