DR. CHARLENE J HICKSON (M.D.) – Otolaryngology Physician, NPI 1417909938

DR. CHARLENE J HICKSON (M.D.) is a healthcare provider. based in Pueblo, Colorado. specializing in OTOLARYNGOLOGY. They hold the professional credentials M.D.. They hold a License No. 39435 (CO). The NPI Number for DR. CHARLENE J HICKSON (M.D.) is 1417909938

Main info

Female
31 Years Of Experience
Accepts Medicare Assignment
Name
DR. CHARLENE J HICKSON (M.D.)
NPI
1417909938
Phone
(719) 557-5855
Address
902 Lakeview Ave
Enumeration Date
16 May 2006
Last Update Date
8 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7207335260
Graduation Year
1995 (31 years ago)
PAC ID
8123095544
Group Practice PAC ID
9638208549
Professional Enrollment ID
I20060612000083
Address ID
CO801047419CA4404XLNXX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

227 OTOLARYNGOLOGY in CO

Provider Addresses for DR. CHARLENE J HICKSON (M.D.)

  • 902 Lakeview Ave

    Pueblo, CO 810043597

    Phone: (719) 557-5855

    Type: Location

  • 1218, South Pueblo Boulevard, Sunnyheights, Pueblo, Pueblo County, Colorado, 81005, United States

    PUEBLO, CO 810051593

    Phone: (719) 566-1277

    Fax: (719) 566-1257

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-06-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060612000083IOtolaryngologyCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes1211$0
View full utilization report →

Insurance plans in this area (ZIP 81004)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638208549View full group profile

Reviews

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Frequently asked questions

What is the standard ID for DR. CHARLENE J HICKSON (M.D.) in the U.S.?
In the U.S., DR. CHARLENE J HICKSON (M.D.) is identified by NPI 1417909938.
Is DR. CHARLENE J HICKSON (M.D.)'s NPI status active today?
Active status means DR. CHARLENE J HICKSON (M.D.)'s NPI record is not deactivated in the public file.
What services align with DR. CHARLENE J HICKSON (M.D.)'s listing?
DR. CHARLENE J HICKSON (M.D.)'s public classification highlights Otolaryngology Physician. Clinical services aligned with this taxonomy classification.
Is DR. CHARLENE J HICKSON (M.D.) tied to Pueblo, Colorado?
If you are local to Pueblo, Colorado, DR. CHARLENE J HICKSON (M.D.) may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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