MR. KEVIN IMMARRI HICKMAN CRNA
NPI 1306120779
Nurse Anesthetist, Certified Registered in Wilkes Barre, PA

Active since October 04, 2011Accepts Medicare Assignment
100/100
CMS Quality Rating
1000 E MOUNTAIN DR, WILKES BARRE, PA 18711(570) 808-7850(570) 808-7855 Get Directions Write a Review

NPPES record last updated: March 9, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mr. Kevin Immarri Hickman Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KEVIN IMMARRI HICKMAN CRNA (NPI 1306120779) is an individual nurse anesthetist, certified registered in Wilkes Barre, Pennsylvania, licensed in Pennsylvania (RN810317) and active in the NPI registry since October 2011. He is a graduate of Other (2011).

NPPES Registry Identity

NPI1306120779
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameMR. KEVIN IMMARRI HICKMANCredential: CRNA
Location Address1000 E MOUNTAIN DRWilkes Barre, PA 18711-0027
Mailing Address100 N Academy AveDanville, PA 17822-4903 · (570) 808-7850 · Fax (570) 808-7855
Fax(570) 808-7855
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateOctober 4, 2011
Last NPPES UpdateMarch 9, 2026
NPPES CertifiedMarch 9, 2026
NPI 1306120779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License Licensed in PA · RN810317
Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

1000 E MOUNTAIN DR, Wilkes Barre, PA 18711

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mr. Kevin Immarri Hickman Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7315119955
PECOS Enrollment IDI20111004000450

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18711 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Quality86.8
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Radiology (Diagnostic Radiology)
1000 E MOUNTAIN DR
WILKES BARRE, PA 18711
Neurological Surgery
1000 E MOUNTAIN DR, MC 37-31
WILKES BARRE, PA 18711
Neurological Surgery
1000 E MOUNTAIN DR
WILKES BARRE, PA 18711
Orthopaedic Surgery
1000 E MOUNTAIN DR
WILKES BARRE, PA 18711
Dermatology
1000 E MOUNTAIN DR
WILKES BARRE, PA 18711
Internal Medicine (Hematology & Oncology)
1000 E MOUNTAIN DR
WILKES BARRE, PA 18711
Internal Medicine (Rheumatology)
1000 E MOUNTAIN DR
WILKES BARRE, PA 18711
Ophthalmology
1000 E MOUNTAIN DR
WILKES BARRE, PA 18711

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1306120779, enumerated as an "individual" on October 04, 2011.

The provider is located at 1000 E MOUNTAIN DR WILKES BARRE, PA 18711 and the phone number is (570) 808-7850.

Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.