Crystal Jennifer Hicks, is a medicare enrolled "Physical Therapist" physician in Tempe, Arizona. Her current practice location is
5110 S Rural Rd Ste 104, Tempe, Arizona. You can reach out to her office (for appointments etc.) via phone at
(480) 222-0655.
Crystal Jennifer Hicks is licensed to practice in Arizona (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1871206177.
Physician's Profile
| Full Name | Crystal Jennifer Hicks |
|---|
| Gender | Female |
|---|
| Speciality | Physical Therapist |
|---|
| Location | 5110 S Rural Rd Ste 104, Tempe, Arizona |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1871206177
- Provider Enumeration Date: 01/02/2023
- Last Update Date: 07/22/2024
Medicare PECOS Information:
- PECOS PAC ID: 3577938984
- Enrollment ID: I20230417000509
Medical Identifiers
Medical identifiers for Crystal Jennifer Hicks such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1871206177 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | LPT-32758 (Arizona) | Secondary |
| 225100000X | Physical Therapist | (Arizona) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Crystal Jennifer Hicks allows following entities to bill medicare on her behalf.
| Entity Name | Bhsm Rehabilitation Llc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1497271431
PECOS PAC ID: 2062773138
Enrollment ID: O20180306002185 |
|---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Crystal Jennifer Hicks is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Crystal Jennifer Hicks,
790 Remington Blvd,
Bolingbrook, IL 60440-4909
Ph: () - | Crystal Jennifer Hicks,
5110 S Rural Rd Ste 104,
Tempe, AZ 85282-7289
Ph: (480) 222-0655 |
Reviews and Comments