Mr Adam L Hickenbotham, OD - Medicare Optometrist in Provo, UT

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Mr Adam L Hickenbotham, OD is a medicare enrolled "Optometrist" provider in Provo, Utah. His current practice location is 122 E 1700 S Bldg 3, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (385) 248-5550.

Mr Adam L Hickenbotham is licensed to practice in Utah (license number 11993238-9934) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1063462778.

Contact Information

Mr Adam L Hickenbotham, OD
122 E 1700 S Bldg 3,
Provo, UT 84606-5644
(385) 248-5550
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameMr Adam L Hickenbotham
GenderMale
SpecialityOptometrist
Location122 E 1700 S Bldg 3, Provo, Utah
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1063462778
  • Provider Enumeration Date: 05/11/2006
  • Last Update Date: 12/03/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 3577576115
  • Enrollment ID: I20220926002120

Medical Identifiers

Medical identifiers for Mr Adam L Hickenbotham such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063462778NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist 2028DT (Kentucky)Secondary
152W00000XOptometrist 11993238-9934 (Utah)Primary
152W00000XOptometrist OPT 12423 TPA (California)Secondary

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. Mr Adam L Hickenbotham allows following entities to bill medicare on his behalf.
Provider NameComplete Eye Care
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1871950444
PECOS PAC ID: 1456657006
Enrollment ID: O20160309000333
Provider NameRocky Mountain University Health Center
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1861141822
PECOS PAC ID: 7012391170
Enrollment ID: O20220908002789
Provider NameRocky Mountain University Of Health Professions Foundation
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1053174417
PECOS PAC ID: 7810439130
Enrollment ID: O20240603000185

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. Mr Adam L Hickenbotham 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 AddressPractice Location Address
Mr Adam L Hickenbotham, OD
147 Sycamore St,
Pikeville, KY 41501-9118

Ph: (606) 218-5522		Mr Adam L Hickenbotham, OD
122 E 1700 S Bldg 3,
Provo, UT 84606-5644

Ph: (385) 248-5550

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.