Organization Active NPI

Robert G Hickes MD PC

  • Legal Medicine
  • Ithaca, NY
National Provider Identifier
1912065392
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
113067 Issued in NY
Legal business name
ROBERT G HICKES MD PC
Practice address
821 Cliff St
Ithaca, NY 14850-2017
Phone
(607) 272-5486
Fax
(607) 272-5966
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert G Hickes, M.D,
Title
Owner
Phone
(607) 272-5486

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193200000X MULTI-SPECIALTY GROUP 173000000X 113067 NY Primary

Addresses

Primary practice location

821 Cliff St
Ithaca, NY 14850-2017

Mailing address

821 Cliff St
Ithaca, NY 14850-2017
Phone (607) 272-5486

Other identifiers 1

IdentifierTypeStateIssuer
00602502MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912065392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 CLIFF ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148502017",
            "telephone_number": "607-272-5486",
            "fax_number": "607-272-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 CLIFF ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148502017",
            "telephone_number": "607-272-5486",
            "fax_number": "607-272-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT G HICKES MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HICKES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-272-5486",
        "authorized_official_credential": "M.D,"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "113067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00602502",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.