Individual provider Active NPI

Cameron Connelly Wick, MD

  • Otolaryngology Physician
  • Cleveland, OH
National Provider Identifier
1063737799
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
2017010083 Issued in MO
Practice address
11100 Euclid Ave Dept
Cleveland, OH 44106-1716
Phone
(216) 844-6000
Fax
(216) 286-5794
NPI assigned
Apr 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 2017010083 MO Primary

Addresses

Primary practice location

11100 Euclid Ave Dept
Cleveland, OH 44106-1716

Mailing address

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-6000

Other practice location 1

3909 Orange Pl Ste 4100
Beachwood, OH 44122-4480
Phone (216) 844-6000

Other practice location 2

8819 Commons Blvd Ste 202
Twinsburg, OH 44087-4103
Phone (216) 844-6000

Other identifiers 2

IdentifierTypeStateIssuer
200045021MedicaidMO
0129517MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241204000305 OH Practitioner - Otolaryngology 8022257310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

Hospital & facility affiliations

  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137
  • Parma Community General Hospital Hospital, Parma, OH, CCN 360041

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System Current Accepting new patients
University Hospitals Medical Group Inc Otolaryngology CurrentSince Nov 21, 2024 Accepting new patients
Multicare Health System Past Accepting new patients
Ozarks Medical Center Otolaryngology Past Accepting new patients

Locations

3909 Orange Pl
Ste 4100
Beachwood, OH 44122
Phone (216) 896-1800

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

11100 Euclid Ave
Cleveland Heights, OH 44106

8819 Commons Blvd
Ste 202
Twinsburg, OH 44087
Phone (216) 844-3013

Interoperability endpoints

  • Direct secure messaging: cwick26166@direct.metrohealth.org
  • Direct secure messaging: cwick611068@ehrdirect.uhhospitals.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1063737799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-6000",
            "fax_number": "216-286-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE DEPT",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-6000",
            "fax_number": "216-286-5794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3909 Orange Pl Ste 4100",
            "address_purpose": "LOCATION",
            "city": "Beachwood",
            "state": "OH",
            "postal_code": "441224480",
            "country_code": "US",
            "telephone_number": "216-844-6000",
            "fax_number": "216-286-5794",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8819 Commons Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Twinsburg",
            "state": "OH",
            "postal_code": "440874103",
            "country_code": "US",
            "telephone_number": "216-844-6000",
            "fax_number": "216-286-5794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICK",
        "first_name": "CAMERON",
        "middle_name": "CONNELLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-06",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "2017010083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200045021",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0129517",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4921 Parkview Pl",
            "address_2": "Dept Otolaryngology, Ste 11A",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.