Tyson Hickle, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD61440052 Issued in WA

Practice address

250 Hospital PL
Soldotna, AK 99669-7559

Phone

(907) 714-4502

Fax

(907) 714-4696

NPI assigned

Apr 3, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Specialty

Emergency Medicine

Education

Creighton University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid-Columbia Medical CenterGroup PAC ID 3779487251, 99 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mid-Columbia Medical Center Hospital, The Dalles, OR, CCN 380001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: thickle180211@direct.ohsu.edu
• Direct secure messaging: thickle1160158@ak.providencedirect.org
• Direct secure messaging: thickle772431@direct.multicare.org

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.

• Mid-Columbia Medical Center

  • General Practice Physician
  • The Dalles, OR
  • NPI 1053409599
  Medicare reassignment Care Compare group NPD
• Yakima Valley Memorial Physicians

  • General Acute Care Hospital
  • Yakima, WA
  • NPI 1306933940
  Medicare reassignment NPD
• Healthcare for the Mid-Columbia Region

  • Emergency Medicine Physician
  • The Dalles, OR
  • NPI 1497797856
  NPD
• Mid-Columbia Medical Center

  • Rural Health Clinic/Center
  • The Dalles, OR
  • NPI 1154351336
  NPD
• Mid-Columbia Medical Center

  • Multi-Specialty Clinic/Center
  • The Dalles, OR
  • NPI 1366809048
  NPD
• Yakima Valley Memorial Physicians

  • Durable Medical Equipment & Medical Supplies
  • Yakima, WA
  • NPI 1366325870
  NPD

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

• Mid-Columbia Medical Center

  • Critical Access Hospital Clinic/Center
  • The Dalles, OR
  • NPI 1306842752
  Care Compare affiliation

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1699193979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE # 673MDG",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995063702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697559",
            "telephone_number": "907-714-4502",
            "fax_number": "907-714-4696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_2": "Box 800699",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-8485",
            "fax_number": "434-982-4118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5955 Zeamer Ave # 673Mdg",
            "address_purpose": "LOCATION",
            "city": "Jber",
            "state": "AK",
            "postal_code": "99506",
            "country_code": "US",
            "telephone_number": "907-580-2778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2811 Tieton Dr",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989023761",
            "country_code": "US",
            "telephone_number": "509-575-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKLE",
        "first_name": "TYSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-03",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0116028145",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD61440052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699522",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thickle1160158@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "250 Hospital Pl",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Chandra Henry, NP
• Rose Maureen Henry, RPH
• McKayla Hensley
• Heritage Place
• Amy Lee Hiatt
• Kandice Hightower
• Stephen L. Hileman, M.D.
• Katelyn Hill
• Lindsey Louise Hill, OTD, OTR/L
• Gregory David Hinz

• Emergency Medicine Physician in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Emergency Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.