NPIMap

Individual provider Active NPI

Brandon Hicks

  • Certified Registered Nurse Anesthetist
  • Bethlehem, PA
National Provider Identifier
1902279615
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN610493 Issued in PA
Practice address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone
(610) 954-5810
NPI assigned
Nov 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN610493 PA Primary

Addresses

Primary practice location

801 Ostrum St
Bethlehem, PA 18015-1000

Mailing address

PO Box 5520
Bethlehem, PA 18015-0520
Phone (610) 954-5810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151221000555 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163723917 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Specialists of Bethlehem PCGroup PAC ID 1355254533, 283 clinicians

Practice addresses (Care Compare)

1872 St Lukes Blvd
Easton, PA 18045-5669
Phone (866) 785-8537

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN610493PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Specialists of Bethlehem, PC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2021 Accepting new patients
Lehigh Valley Anesthesia Services, P. C. Nurse Anesthetist, Certified Registered CurrentSince Dec 14, 2015 Accepting new patients

Locations

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

1872 St Lukes Blvd
Easton, PA 18045
Phone (484) 503-1200

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Organizations & group practices 2

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 8

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": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1902279615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5520",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180150520",
            "telephone_number": "610-954-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "610-954-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-03",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN610493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.