Justin Hickman, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

0101272390 Issued in VA

Practice address

5115 Bernard Dr Ste 201
Roanoke, VA 24018-4367

Phone

(540) 345-0289

Fax

(540) 345-9569

NPI assigned

Mar 24, 2017

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA, CA2 enrollments

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 2

Specialty

Anesthesiology

Education

Virginia Commonwealth University, School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Medical Group of Santa Maria IncGroup PAC ID 9537143078, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Anesthesia Medical Group of Santa Maria Inc

  • Anesthesiology Physician
  • Santa Maria, CA
  • NPI 1225024284
  Medicare reassignment Care Compare group
• Acv Inc

  • Anesthesiology Physician
  • Roanoke, VA
  • NPI 1881927259
  Medicare reassignment NPD
• Anesthesiology Consultants of Virginia, Inc

  • Anesthesiology Physician
  • Roanoke, VA
  • NPI 1225016603
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Health

  • General Acute Care Hospital
  • Santa Maria, CA
  • NPI 1760510937
  Care Compare affiliation

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1942731575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "address_2": "BOX 800710",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-982-0629",
            "fax_number": "434-982-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 BERNARD DR STE 201",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184367",
            "telephone_number": "540-345-0289",
            "fax_number": "540-345-9569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101272390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942731575",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942731575",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James W Herron, LPC, LMFT
• Marjorie Ruth Herron
• Alison Hester, D.O.
• Karen Louise Hetherington, LPC
• Patrick E Hickey, ARNP
• Courtney Bryanne Hicks, PA
• Marsha M Hicks, LCSW
• Rachel Marie Hicks, MSN BSN RN AG-ACNP
• Beth A Higgins, OTR
• Lydia Katherine Higgs, MS, LCGC

• Anesthesiology Physician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Anesthesiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.