Keric Lickerman, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2023026688 Issued in MO

Practice address

3635 Vista Ave
Saint Louis, MO 63110-2500

Phone

(314) 268-7133

Fax

(314) 577-8516

NPI assigned

Mar 26, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Emergency Medicine

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
• SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104

Merit-based Incentive Payment System (MIPS)

Final score

87.3 of 100Reported as group

Quality

70.94

Improvement activities

40

Cost

92.94

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: klickerman372281@direct-ehr-ssmhc.com

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.

• Cep America, LLC

  • Emergency Medicine Physician
  • Saint Louis, MO
  • NPI 1619332046
  Medicare reassignment Care Compare group NPD
• SSM Health Care Group

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1306589544

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Saint Charles, MO
  • NPI 1477108892
  NPD
• SSM Health Care Group

  • Dermatopathology Physician
  • Saint Louis, MO
  • NPI 1932844495
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD

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

• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Bridgeton, MO
  • NPI 1598835308
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Lake St Louis, MO
  • NPI 1871665380
  Care Compare affiliation

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1730716705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 VISTA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102500",
            "telephone_number": "314-268-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 VISTA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102500",
            "telephone_number": "314-268-7133",
            "fax_number": "314-577-8516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICKERMAN",
        "first_name": "KERIC",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2023026688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Lichtenberg, BCABA
• Andrew Lichter, MD
• Amy Kathleen Licis, MD
• Karen Albers Lickenbrock, M.D.
• Kevin James Lickenbrock, M.D.
• Nicole Licklider
• Jerry M Liddell, DPM
• Amy Liddy, MA/CCC-SLP
• Joseph Michael Lider, PHARMD
• Adam P Liebendorfer, MD

• Emergency Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.