Matthew Thomas Hickling, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

382896 Issued in NY

Practice address

6 Wellness Way Ste 101
Latham, NY 12110-2156

Phone

(518) 782-7733

Fax

(518) 782-0800

NPI assigned

Aug 24, 2018

Last updated

Feb 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Care Physicians, PC

  dba CapitalCare Developmental Pediatrics

  • Developmental - Behavioral Pediatrics Physician
  • Latham, NY
  • NPI 1164704136
  NPD
• Community Care Physicians, PC

  dba Community Care Lab Care

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1023380714
  NPD (past)

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1811478191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 101",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-7733",
            "fax_number": "518-782-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKLING",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-24",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Hendrick
• Jaime Rose Hermann
• Allen Herr
• Tera Nikole Hetrick-Stein, M.D.
• Richard Heyman
• Michelle S. Higgins, NP
• Jennifer Lynn Hilligrass, RPA-C
• Laurie Ann Hiss, PT
• Katherine Hodge
• Eugene Hoffert

• Pediatric Nurse Practitioner in Latham, NY
• Providers in Latham, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.