Scott C Wickless, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS15286 Issued in FL

Practice address

1801 S Osprey Ave Unit 201
Sarasota, FL 34239-3625

Phone

(941) 957-4767

Fax

(941) 955-7334

NPI assigned

Aug 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO, NM2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

DermatologyAlso: Pathology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bella Derma, LLCGroup PAC ID 2466424072, 20 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.01 of 100Reported as group

Quality

100

Improvement activities

40

Cost

83.36

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bella Derma, LLC

  dba Aspen and Vail Dermatology

  • Dermatology Physician
  • Edwards, CO
  • NPI 1730106642
  Medicare reassignment Care Compare group NPD
• Epiphany Dermatology of New Mexico, LLC

  • Dermatology Physician
  • Albuquerque, NM
  • NPI 1447615760
  Medicare reassignment NPD
• Cockerell Dermatopathology PA

  • Dermatopathology (Pathology) Physician
  • Dallas, TX
  • NPI 1528300837
  NPD
• Loyola University Physician Foundation

  • General Practice Physician
  • Maywood, IL
  • NPI 1235148891
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1043222714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 MEMORIAL HWY STE 150",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336347516",
            "telephone_number": "813-333-1528",
            "fax_number": "813-255-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 S OSPREY AVE UNIT 201",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342393625",
            "telephone_number": "941-957-4767",
            "fax_number": "941-955-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKLESS",
        "first_name": "SCOTT",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "FL",
            "license": "OS15286",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS15286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107709300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swickless@dmp.emedirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1801 S Osprey Ave Unit 201",
            "city": "Sarasota",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342393625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cherish Ann Whittenburg
• Whole Health Medical LLC
• Whole Person Healing Center Inc
• Wholesome Lactation Care, LLC
• Wholistic Health Clinic, Inc
• Heather Wicklund, NP
• Wicks in-House Gulfcoast Therapy PLLC
• Kevin Douglas Wicks, PT
• Meghan K Wicks, P.T.
• Christopher Widell

• Dermatology Physician in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.