Individual provider Active NPI

David Fickett, P.A.

  • Physician Assistant
  • Royal Oak, MI
National Provider Identifier
1942213061
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012193 Issued in MI
Practice address
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone
(248) 898-4021
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2243 NE
Surgical Physician Assistant 363AS0400X PA00051 TX
Physician Assistant 363A00000X 5601012193 MI Primary
Physician Assistant 363A00000X PA-850 AR

Addresses

Primary practice location

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other practice location 1

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-8432

Other practice location 2

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other practice location 3

405 Londonderry Dr
Suite 301A
Waco, TX 76712-7924
Phone (254) 741-6333

Other identifiers 1

IdentifierTypeStateIssuer
200304802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100922000526 TX Practitioner - Physician Assistant 8628194180 Reassigns benefits to 1 organization
I20240509003198 MI Practitioner - Physician Assistant 8628194180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Southwestern Medical School at Dallas, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health AllianceGroup PAC ID 6305731068, 119 clinicians

Practice addresses (Care Compare)

301 Richland W Cir
Providence Internal Medicine Clinic
Waco, TX 76712-7932
Phone (254) 537-6200

340 Richland W Cir
Ascension Medical Group Providence
Waco, TX 76712-7919
Phone (254) 537-6050

342 Richland W Cir
Waco, TX 76712-7919
Phone (254) 537-6600

6901 Medical Pkwy
Waco, TX 76712-7910
Phone (254) 751-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601012193MIMDPhysician Assistant
2243NEMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health Alliance CurrentSince Aug 1, 2010 Accepting new patients
Central Texas Cardiovascular Past Accepting new patients

Locations

405 Londonderry Dr
Ste 301
Waco, TX 76712
Phone (241) 741-6333

6901 Medical Pkwy
Waco, TX 76712
Phone (254) 751-4000

405 Londonderry Dr
Ste 301A
Waco, TX 76712
Phone (254) 741-6333

301 Richland West Cir
Waco, TX 76712
Phone (254) 537-6200

405 Londonderry Dr
Ste 200
Waco, TX 76712
Phone (254) 224-8188

Interoperability endpoints

  • Direct secure messaging: david.fickett.1@9635.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/1902/brand/6/csg/45/fhir/r4

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1942213061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-4021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-964-8432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4301 W Markham St # 783",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Londonderry Dr",
            "address_2": "Suite 301A",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767127924",
            "country_code": "US",
            "telephone_number": "254-741-6333",
            "fax_number": "254-741-6364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FICKETT",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NE",
            "license": "2243",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA00051",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012193",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-850",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200304802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.