NPIMap

Individual provider Active NPI

Jeff Charles Rickert, P.A.

  • Physician Assistant
  • Rockwall, TX
National Provider Identifier
1972719151
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04912 Issued in TX
Practice address
1005 W Ralph M Hall Pkwy
Suite 201
Rockwall, TX 75032-6658
Phone
(972) 771-9081
Fax
(972) 772-7102
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA04912 TX Primary

Addresses

Primary practice location

1005 W Ralph M Hall Pkwy
Suite 201
Rockwall, TX 75032-6658

Mailing address

PO Box 1029
Rockwall, TX 75087-1029
Phone (972) 771-9081

Other identifiers 1

IdentifierTypeStateIssuer
PA04912OtherTXPHYSICIAN ASSISTANT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091212000072 TX Practitioner - Physician Assistant 7012057656 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Les T. Sandknop, D.O. PAGroup PAC ID 2860387578, 11 clinicians

Practice addresses (Care Compare)

4006 Wellington
Suite 100
Greenville, TX 75402
Phone (903) 450-4788

6785 Horizon Rd
Suite 100
Heath, TX 75032-7711
Phone (972) 771-9000

Hospital & facility affiliations

  • Baylor Scott and White Medical Center Lake Pointe Hospital, Rowlett, TX, CCN 450742
  • Texas Health Presbyterian Hospital Rockwall Hospital, Rockwall, TX, CCN 670044

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jan 1, 2016 Accepting new patients
Healthtexas Provider Network CurrentSince Jan 1, 2016 Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

1005 W Ralph Hall Pkwy
Ste 201
Rockwall, TX 75032
Phone (888) 990-0663

9500 Lakeview Pkwy
Ste 200
Rowlett, TX 75088
Phone (214) 553-9009

Interoperability endpoints

  • Direct secure messaging: jeff.rickert@sandknophg.eclinicaldirectplus.com

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 11

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1972719151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1029",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750871029",
            "telephone_number": "972-771-9081",
            "fax_number": "972-772-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 W RALPH M HALL PKWY",
            "address_2": "SUITE 201",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750326658",
            "telephone_number": "972-771-9081",
            "fax_number": "972-772-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKERT",
        "first_name": "JEFF",
        "middle_name": "CHARLES",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT",
            "identifier": "PA04912",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

Verify at the official NPI Registry.