Individual provider Active NPI

Michael James Hicks, MD

  • Diagnostic Radiology Physician
  • Ann Arbor, MI
National Provider Identifier
1982125704
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301500733 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Jul 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4301112119 MI
Diagnostic Radiology Physician 2085R0202X 4301500733 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220715001119 MI Practitioner - Diagnostic Radiology 1759656028 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Michigan State University College of Human Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Medical Imaging PCGroup PAC ID 4688637697, 22 clinicians

Practice addresses (Care Compare)

1141 S State Rd
Davison, MI 48423-1964
Phone (810) 658-4454

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Current Accepting new patients
Metropolitan Hospital CurrentSince Sep 1, 2022 Accepting new patients
Regents of the University of Michigan CurrentSince Jun 30, 2022 Accepting new patients
Regents of the University of Michigan Diagnostic Radiology CurrentSince Jun 30, 2022 Accepting new patients
Metropolitan Hospital Past Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

1500 E Medical Center Dr
#D
Ann Arbor, MI 48109
Phone (734) 936-5823

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1498867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1982125704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-01",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301112119",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301500733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.