Robert Hickman, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G73026 Issued in CA

Practice address

4545 La Jolla Village Dr Ste C5
San Diego, CA 92122-1241

Phone

(888) 663-6331

NPI assigned

Nov 15, 2006

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 1

Other names 1

• Robert Lee Hickman Jr. Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Family Practice

Education

University of California, Irvine, California College of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

One Medical Group IncGroup PAC ID 2567623739, 330 clinicians

Practice addresses (Care Compare)

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.

• One Medical Group, Inc.

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1467781641
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Family Medicine

  Medicare reassignment NPD
• One Medical Group, Inc

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1801666904
  NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Richmond, CA
  • NPI 1235226531

  Family Medicine

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• One Medical Group, Inc

  • Family Medicine Physician
  • Tigard, OR
  • NPI 1891521134
  NPD
• Regents of the University of California

  • Pharmacy
  • San Diego, CA
  • NPI 1598786576
  NPD (past)
• The Regents of the University of California

  • Community Health Clinic/Center
  • Carlsbad, CA
  • NPI 1619431244
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1952473779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 LA JOLLA VILLAGE DR STE C5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221241",
            "telephone_number": "888-663-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G73026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G730260",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "Corporate Center Pkwy",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "HICKMAN",
            "middle_name": "LEE",
            "suffix": "JR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jeffrey J Hickman, IDC
• Kelley Hickman, CCC-SLP
• Lindy Hickman
• Lisa M Hickman, RD, CNSD
• Rebecca Rose Hickman
• Steven Douglas Hickman, PSY.D.
• Warren Daichi Hickman
• Kalanamonea Hicks Graham
• Alyssa Hicks
• Breanne Hicks

• Family Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.