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RICKY L KIDMAN PA-C
NPI 1962466532
Physician Assistant - Medical in Aynor, SC

Active since April 12, 2006PECOS EnrolledAccepts Medicare Assignment
72.72/100
CMS Quality Rating
51 11TH AVENUE, AYNOR, SC 29511(843) 358-3700(843) 358-3707 Get Directions Write a Review

NPPES record last updated: August 21, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 22, 2022, Nov 17, 2021, Oct 15, 2020 (3 updates tracked since 2020).

About Ricky L Kidman Pa-c NPPES

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

RICKY L KIDMAN PA-C (NPI 1962466532) is an individual medical provider in Aynor, South Carolina, licensed in South Carolina (1094) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Conway Medical Center, and is a graduate of University Of Nebraska College Of Medicine (1994).

NPPES Registry Identity

NPI1962466532
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameRICKY L KIDMANCredential: PA-C
Location Address51 11TH AVENUEAynor, SC 29511-3249
Mailing Address300 Singleton Ridge Rd, Attention Pns CredentialingConway, SC 29526-9142 · (843) 234-6946
Phone(843) 358-3700
Fax(843) 358-3707
Sole ProprietorNo
Medical School CMSUniversity Of Nebraska College Of MedicineGraduated 1994
Enumeration DateApril 12, 2006
Last NPPES UpdateAugust 21, 20253 updates tracked since enumeration
NPPES CertifiedAugust 21, 2025
✔ NPI 1962466532 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in SC · 1094
51 11TH AVENUE, Aynor, SC 29511
Open in Google Maps ↗

Other Identifiers 1

Medicaid1140PASC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.Insurance ›

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

Ricky L Kidman Pa-c 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 ID9032117122
PECOS Enrollment IDI20061128000420
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428
This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.
64 services58 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
29 services23 patients
Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880
A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.
14 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Conway Medical Center

Acute Care Hospitals · Conway, SC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420049
Location300 Singleton Ridge RoadConway, SC 29526 · Horry County
Emergency services Birthing friendly

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.

72.72/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality60.98
Promoting Interoperability100
Improvement Activities40
Cost48.1

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
70%141 patients4/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
59%255 patients3/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
16%112 patients1/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%752 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
49%419 patients3/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 97% · 190 patients
Patients tobacco: 13% · 23 patients
74%190 patients4/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
2 suppliers11 claims307 services$7.66 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
2 suppliers11 claims4,978 services$0.39 avg. paid by Medicare
Enteral nutrition infusion pump, any type B9002
Other-Enteral and Parenteral · category OB005N
1 supplier12 claims12 services$75.74 avg. paid by Medicare
Iv pole E0776
DME-Other DME · category DE000N
2 suppliers12 claims12 services$13.88 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

MARION PHYSICIAN SERVICES LLC
Clinic/Center (Rural Health)
51 11TH AVENUE
AYNOR, SC 29511
Horry County (843) 358-3700
MARION REGIONAL HEALTHCARE SYSTEM
Clinic/Center (Rural Health)
51 11TH AVENUE
AYNOR, SC 29511
Horry County (843) 431-2405

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ricky Kidman's NPI number?

The NPI number for Ricky Kidman is 1962466532. It was assigned to this individual provider in the NPPES registry on April 12, 2006.

Where is Ricky Kidman located?

Ricky Kidman practices at 51 11th Avenue, Aynor, SC 29511. The listed phone number is (843) 358-3700.

What is Ricky Kidman's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Ricky Kidman enrolled in Medicare?

Yes. Ricky Kidman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Ricky Kidman accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina, First Choice Next and Molina Healthcare list Ricky Kidman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Ricky Kidman affiliated with any hospitals?

According to CMS data, Ricky Kidman is affiliated with Conway Medical Center.

When was this NPI record last updated?

The NPPES record for Ricky Kidman was last updated on August 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.