Individual provider Active NPI

Ximena Alejandra Prieto Hicks, M.D.

  • Psychiatry Physician
  • Worthington, OH
National Provider Identifier
1720370984
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35123331 Issued in OH
Practice address
1035 Proprietors Rd
Worthington, OH 43085-3284
Phone
(614) 785-1115
Fax
(614) 785-0095
NPI assigned
May 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35123331 OH Primary

Addresses

Primary practice location

1035 Proprietors Rd
Worthington, OH 43085-3284

Mailing address

1035 Proprietors Rd
Worthington, OH 43085-3284
Phone (614) 785-1115

Other identifiers 1

IdentifierTypeStateIssuer
35123331OtherOHSTATE MEDICAL BOARD OF OHIO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20140603001142 OH Practitioner - Psychiatry 4486877800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Ohio Counseling Inc.Group PAC ID 1052203445, 14 clinicians

Practice addresses (Care Compare)

1035 Proprietors Rd
Worthington, OH 43085-3230
Phone (614) 785-1115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35123331OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Counseling Inc. CurrentSince Jan 1, 2016 Accepting new patients

Locations

1035 Proprietors Rd
Worthington, OH 43085
Phone (614) 785-1115

Organizations & group practices 1

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": "1304640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1720370984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 PROPRIETORS RD",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853284",
            "telephone_number": "614-785-1115",
            "fax_number": "614-785-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PROPRIETORS RD",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853284",
            "telephone_number": "614-785-1115",
            "fax_number": "614-785-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIETO HICKS",
        "first_name": "XIMENA",
        "middle_name": "ALEJANDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-06",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35123331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL BOARD OF OHIO",
            "identifier": "35123331",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, OH

Sources for this page

Verify at the official NPI Registry.