Individual provider Active NPI

Kaitlyn Paige Hickman, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1790541365
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17715 Issued in TX
Practice address
21 Spurs LN Ste 310
San Antonio, TX 78240-1679
Phone
(210) 615-8332
Fax
(800) 699-0265
NPI assigned
Feb 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17715 TX Primary
Internal Medicine Physician 207R00000X PA17715 TX

Addresses

Primary practice location

21 Spurs LN Ste 310
San Antonio, TX 78240-1679

Mailing address

10740 N Gessner Rd Ste 310
Houston, TX 77064-1240
Phone (281) 897-0416

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240429003409 TX Practitioner - Physician Assistant 0244670990 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Ear, Nose and Throat Specialists, PLLCGroup PAC ID 5799770202, 123 clinicians
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

21 Spurs LN
Suite 310
San Antonio, TX 78240-1679
Phone (210) 615-8332

4438 Centerview
San Antonio, TX 78228-1440
Phone (210) 280-0040

5715 Rogers Rd
Suite 128
San Antonio, TX 78251-3764
Phone (210) 249-4838

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

9301 Pinecroft Dr
Suite 150
Shenandoah, TX 77380-3182
Phone (281) 362-1368

Hospital & facility affiliations

  • Baptist Medical Center Hospital, San Antonio, TX, CCN 450058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA Internal Medicine CurrentSince Apr 1, 2024 Accepting new patients
San Antonio Head & Neck Surgical Associates, P.a. Past Accepting new patients
Noble Anesthesia Partners, PLLC Past Accepting new patients

Locations

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

4243 E Southcross Blvd
Ste 205
San Antonio, TX 78222
Phone (210) 304-3500

448 Castroville Rd
San Antonio, TX 78207
Phone (210) 434-1400

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

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 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": "1708560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1790541365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10740 N GESSNER RD STE 310",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770641240",
            "telephone_number": "281-897-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SPURS LN STE 310",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401679",
            "telephone_number": "210-615-8332",
            "fax_number": "800-699-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "KAITLYN",
        "middle_name": "PAIGE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-22",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17715",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "PA17715",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.