Individual provider Active NPI

Michael William Hickman, DO

  • Emergency Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1912137456
Registry record updated Jul 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
005290 Issued in AZ
Practice address
4730 E Indian School Rd
#211
Phoenix, AZ 85018-5441
Phone
(602) 354-3491
Fax
(602) 595-8567
NPI assigned
Jul 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 005290 AZ Primary

Addresses

Primary practice location

4730 E Indian School Rd
#211
Phoenix, AZ 85018-5441

Mailing address

4730 E Indian School Rd
#211
Phoenix, AZ 85018-5441
Phone (602) 354-3491

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20090917000116 AZ Practitioner - Emergency Medicine 7810043874 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Group of Arizona Professional CorporationGroup PAC ID 1355596644, 102 clinicians

Practice addresses (Care Compare)

18701 N 67TH Ave
Glendale, AZ 85308-7101
Phone (602) 561-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Group of Arizona Professional Corporation Emergency Medicine CurrentSince Feb 1, 2013 Accepting new patients
Arizona Acute Medical Services 1 PC CurrentSince Aug 15, 2022 Accepting new patients
Emurgent Care PLLC Past Accepting new patients

Locations

18701 N 67th Ave
Glendale, AZ 85308
Phone (623) 561-1000

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

1930 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 532-1000

16815 W Bell Rd
Surprise, AZ 85374
Phone (623) 244-2400

Organizations & group practices 3

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 2

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": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247788800000",
    "number": "1912137456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 E INDIAN SCHOOL RD",
            "address_2": "#211",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185441",
            "telephone_number": "602-354-3491",
            "fax_number": "602-595-8567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 E INDIAN SCHOOL RD",
            "address_2": "#211",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185441",
            "telephone_number": "602-354-3491",
            "fax_number": "602-595-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "MICHAEL",
        "middle_name": "WILLIAM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-17",
        "last_updated": "2009-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "005290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.