1. Home
  2. Directory
  3. Minnesota
  4. St Louis Park
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

SAMRA HICKEY
NPI 1972260768
Student in an Organized Health Care Education/Training Program in St Louis Park, MN

Active since November 29, 2021PECOS EnrolledAccepts Medicare Assignment
5354 PARKDALE DR, ST LOUIS PARK, MN 55416(888) 364-5977 Get Directions Write a Review

NPPES record last updated: November 29, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Samra Hickey NPPES

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

SAMRA HICKEY (NPI 1972260768) is an individual student in an organized health care education/training program in St Louis Park, Minnesota and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1972260768
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameSAMRA HICKEY
Location Address5354 PARKDALE DRSt Louis Park, MN 55416-1603
Mailing Address11251 Xavier CirBloomington, MN 55437-3143
Phone(888) 364-5977
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateNovember 29, 2021
NPPES CertifiedNovember 19, 2021
✔ NPI 1972260768 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

5354 PARKDALE DR, St Louis Park, MN 55416
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.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

Samra Hickey 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 ID7517301112
PECOS Enrollment IDI20240222002277
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.

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.

SHARON R KOUKKARI LLC
Community/Behavioral Health
5354 PARKDALE DR, SUITE 300
ST LOUIS PK, MN 55416
Hennepin County (512) 889-1692
SHARON R KOUKKARI M.S., L.P.
Psychologist
5354 PARKDALE DR, SUITE 300
ST LOUIS PARK, MN 55416
Hennepin County (612) 889-1692
DR. ANNA LEIGH TIERNEY
Psychologist (Clinical)
5354 PARKDALE DR, #2
ST LOUIS PARK, MN 55416
Hennepin County (651) 645-5323
MS. NATALIE EILEEN LAU MA, LMFT
Marriage & Family Therapist
5354 PARKDALE DR, SUITE 200
ST LOUIS PARK, MN 55416
Hennepin County (651) 645-5323
MS. CODY L GRANDA M.S., LMFT
Marriage & Family Therapist
5354 PARKDALE DR, SECOND FLOOR
MINNEAPOLIS, MN 55416
Hennepin County (651) 645-5323
ERIN BARNES RD
Dietitian, Registered
5354 PARKDALE DR
ST LOUIS PARK, MN 55416
Hennepin County (651) 645-5323
LAURA BURBANK RD, LD
Dietitian, Registered
5354 PARKDALE DR
ST LOUIS PARK, MN 55416
Hennepin County (651) 645-5323
JENNIE LASKOW LPCC
Counselor (Professional)
5354 PARKDALE DR, SUITE 200
ST LOUIS PARK, MN 55416
Hennepin County (651) 645-5323

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 Samra Hickey's NPI number?

The NPI number for Samra Hickey is 1972260768. It was assigned to this individual provider in the NPPES registry on November 29, 2021.

Where is Samra Hickey located?

Samra Hickey practices at 5354 Parkdale Dr, St Louis Park, MN 55416. The listed phone number is (888) 364-5977.

What is Samra Hickey's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Samra Hickey enrolled in Medicare?

Yes. Samra Hickey 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 Samra Hickey accept?

Health plans from HealthPartners list Samra Hickey 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.

When was this NPI record last updated?

The NPPES record for Samra Hickey was last updated on November 29, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.