Individual provider Active NPI

Patrick W Kicker, D.O.

  • Pulmonary Disease Physician
  • El Paso, TX
National Provider Identifier
1730475237
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
S4793 Issued in TX
Practice address
2000 Transmountain Rd Ste B
El Paso, TX 79911-3602
Phone
(915) 215-8400
Fax
(915) 612-9254
NPI assigned
Jun 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0102203261 VA
Internal Medicine Physician 207R00000X S4793 TX
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X S4793 TX Primary

Addresses

Primary practice location

2000 Transmountain Rd Ste B
El Paso, TX 79911-3602

Mailing address

5130 Gateway Blvd E
Msc51015
El Paso, TX 79905-0001
Phone (915) 215-4480

Other practice location 1

5005 N Piedras St
Graduate Medical Education
El Paso, TX 79920-5001
Phone (915) 742-2521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220623000394 TX Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 0143535393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center El PasoGroup PAC ID 7517864754, 306 clinicians

Practice addresses (Care Compare)

2000 Trans Mountain Rd
Suite B
El Paso, TX 79911-3602
Phone (915) 215-8400

Hospital & facility affiliations

  • The Hospitals of Providence Transmountain Campus Hospital, El Paso, TX, CCN 670120
  • Sierra Medical Center Hospital, El Paso, TX, CCN 450668

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S4793TXMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso CurrentSince Aug 1, 2022 Accepting new patients
Texas Tech University Health Sciences Center El Paso Internal Medicine Current Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Aug 1, 2022 Accepting new patients
Texas Tech University Health Sciences Center Odessa Internal Medicine Past Accepting new patients

Locations

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

Organizations & group practices 4

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 3

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": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1730475237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 GATEWAY BLVD E",
            "address_2": "MSC51015",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799050001",
            "telephone_number": "915-215-4480",
            "fax_number": "915-215-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 TRANSMOUNTAIN RD STE B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799113602",
            "telephone_number": "915-215-8400",
            "fax_number": "915-612-9254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5005 N Piedras St",
            "address_2": "Graduate Medical Education",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799205001",
            "country_code": "US",
            "telephone_number": "915-742-2521",
            "fax_number": "915-742-2653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KICKER",
        "first_name": "PATRICK",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102203261",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S4793",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "S4793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.