DR. PAUL SAMUEL HICKS (NPI# 1255366217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255366217 |
| Entity Type | Individual |
| Full Name | DR. PAUL SAMUEL HICKS |
| Credential | M.D. |
| Practice Address |
602 Ivy St Elmira NY 14905-1646 |
| Mailing Address |
571 Saint Josephs Blvd Fl 2 Elmira NY 14901-3230 |
| Practice Telephone | 6077374333 |
| Practice Fax Number | 6077374271 |
| Mailing Telephone | 6072712050 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2016-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
169764 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 001194150 | 05 | |
| NY | 01415750 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447312145 | Paul Johnson Hicks | Urology | 1106 Pampa St, Pasadena, TX 77504-1632 | 2006-12-16 |
| 1215948278 | Paul Brently Hicks | Psychiatry & Neurology | 2401 S Main St, Temple, TX 76508-5296 | 2006-08-11 |
| 1306822457 | Paul C Hicks | Family Medicine | 50 N. Wilson Road, Columbus, OH 43204 | 2005-12-21 |
| 1508982539 | Paul Preston Hicks Jr. | Dentist | 1707 East Third Street, Farmville, VA 23901-0401 | 2007-03-21 |
| 1679625446 | Paul William Hicks | Dentist | 108 Whipple St, Prescott, AZ 86301-1706 | 2007-01-18 |
| Street Address |
602 IVY ST |
| City | ELMIRA |
| State | NY |
| Zip Code | 14905-1646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174598999 | Carl M. Charnetski | Internal Medicine | 602 Ivy St, 2nd Floor, Elmira, NY 14905-1646 | 2006-02-23 |
| 1366080137 | Erin Rose Terry | Physical Therapist | 602 Ivy St, Elmira, NY 14905-1646 | 2019-12-12 |
| 1578101341 | Bruce Stropko | Physical Therapist | 602 Ivy St, Elmira, NY 14905-1646 | 2019-12-12 |
| 1811416589 | Sarah J Brimmer | Nurse Practitioner | 602 Ivy St, Elmira, NY 14905-1646 | 2017-09-14 |
| 1487000923 | Ryan Matthew White | Student in an Organized Health Care Education/Training Program | 602 Ivy St, Elmira, NY 14905-1646 | 2016-05-13 |
| 1689038853 | Faisal Noorzad | Student in an Organized Health Care Education/Training Program | 602 Ivy St, Elmira, NY 14905-1646 | 2016-04-13 |
| 1598129868 | Kenneth Onuorah | Family Medicine | 602 Ivy St, Elmira, NY 14905-1646 | 2016-04-12 |
| 1063876472 | Benjamin King | Student in an Organized Health Care Education/Training Program | 602 Ivy St, Elmira, NY 14905-1646 | 2016-04-12 |
| 1386028843 | Knickerbocker Dialysis Inc | Clinic/Center | 602 Ivy St, Elmira, NY 14905-1646 | 2015-07-15 |
| 1679960066 | Donald Ray Foster | Internal Medicine | 602 Ivy St, Elmira, NY 14905-1646 | 2015-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780234146 | Theron Bennett | Technician | 900 West First Street, Elmira, NY 14905 | 2019-09-18 |
| 1558893792 | Zhezheng Li | Student in an Organized Health Care Education/Training Program | 600 Roe Street, Elmira, NY 14905 | 2017-03-28 |
| 1932555885 | Mitchell Pearce | Student in an Organized Health Care Education/Training Program | 602 Ivy Street, Elmira, NY 14905 | 2016-05-10 |
| 1982974465 | Chris Cook | Registered Nurse | 110 Hendy Ave, Elmira, NY 14905 | 2011-12-30 |
| 1578795290 | Richard Grinstead | Radiology | Arnot Ogden Medical Center, 600 Roe Ave, Elmira, NY 14905 | 2009-08-13 |
| 1033343967 | Janice Elaine Jackson | Registered Nurse | 1135 Hoffman Street, Elmira, NY 14905 | 2009-05-06 |
| 1598823361 | Obrien Hearing Aid Center | Hearing Aid Equipment | 227 Hoffman St, Elmira, NY 14905 | 2006-12-05 |
| 1487712634 | Robert Gordon Lyon | Dentist | 208 Walnut Street, Elmira, NY 14905 | 2006-12-04 |
| 1215009600 | Twin Tiers Dental Pllc | Dentist | 420 West Water St, Elmira, NY 14905 | 2006-11-14 |
| 1356432348 | Womens Health Services of Elmira | Obstetrics & Gynecology | 600 Fitch St Su 102, Elmira, NY 14905 | 2006-09-27 |
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| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871614289 | Twin Tier Cardiovascular Assoc. | Internal Medicine | 200 Madison Ave, Suite 2b, Elmira, NY 14901-3218 | 2007-04-03 |
| 1528122116 | Lawrence Laifer | Internal Medicine | 602 Ivy St, Elmira, NY 14905-1646 | 2006-12-20 |
| 1588767453 | Dominic J. Romeo | Internal Medicine | 200 Madison Ave, Elmira, NY 14901-3218 | 2006-09-06 |
| 1386755478 | Abdul Waheed | Internal Medicine | 200 Madison Ave, Suite 2b, Elmira, NY 14901-3218 | 2006-08-31 |
| 1689780819 | Rocco D Grella | Internal Medicine | 602 Ivy St, 1st Floor, Elmira, NY 14905-1646 | 2006-08-21 |
| 1568493112 | William Arthur Deluccia Jr. | Internal Medicine | 602 Ivy St, 2nd Floor, Elmira, NY 14905-1646 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548738 | St. Peter's Health Partners Medical Associates, P.C. | Internal Medicine | 2546 Balltown Road Suite 300, Cardiology Associates of Schenectady, Schenectady, NY 12309-1079 | 2020-11-03 |
| 1649871260 | Advanced Cardiovascular Diagnostics, Pllc | Internal Medicine | 410 Lakeville Road Suite 209, New Hyde Park, NY 11042 | 2020-11-02 |
| 1801495320 | Guler Cardiology and Wellness | Internal Medicine | 34 Swan St Ste 3, Batavia, NY 14020-3292 | 2020-10-26 |
| 1174138382 | Southern Westchester Medical PC | Internal Medicine | 944 N Broadway Ste G04, Yonkers, NY 10701-1307 | 2020-09-14 |
| 1922628320 | Phuong Dinh Lam Mac | Internal Medicine | 1400 Pelham Pkwy S Rm 5, Bronx, NY 10461-1197 | 2020-04-26 |
| 1114547064 | Lotus Cardiovascular Care Pllc | Internal Medicine | 198 Oakley Ave, Elmont, NY 11003-2520 | 2020-04-21 |
| 1841824885 | Raman Kumar Md Pllc | Internal Medicine | 333 Broadway Ste 1, Amityville, NY 11701-2719 | 2020-02-28 |
| 1578197729 | North Shore Onsite Medical Diagnostic P.C. | Internal Medicine | 7418 41st Ave, Elmhurst, NY 11373-5601 | 2020-02-26 |
| 1720624604 | Atlantic Cardiovascular Care PC | Internal Medicine | 5114 Post Rd Fl 2, Bronx, NY 10471-3010 | 2019-11-26 |
| 1508401217 | Atlantic Cardiovascular Care PC | Internal Medicine | 5114 Post Rd, Bronx, NY 10471-3010 | 2019-11-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.