Wade Alden Dickinson, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

A62554 Issued in CA

Practice address

3152 N Millbrook Ave
#Suite B
Fresno, CA 93703-1459

Phone

(559) 244-0133

Fax

(559) 244-0148

NPI assigned

Aug 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Obstetrics/Gynecology

Education

Texas Tech University Health Science Center School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Women'S Healthcare Medical Group IncGroup PAC ID 4981987559, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093
• Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Valley Women'S Healthcare Medical Group, Inc

  • Obstetrics & Gynecology Physician
  • Fresno, CA
  • NPI 1154873230
  Medicare reassignment Care Compare group
• Omni Women'S Health Medical Group, Inc

  • Clinical Medical Laboratory
  • Fresno, CA
  • NPI 1891997813
  NPD (past)
• Omni Womens Health Medical Group Inc

  • Gynecology Physician
  • Fresno, CA
  • NPI 1396721197
  NPD (past)

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

• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Clovis, CA
  • NPI 1316027709
  Care Compare affiliation
• Saint Agnes Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1205845567
  Care Compare affiliation

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1104827922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937264301",
            "telephone_number": "559-495-3120",
            "fax_number": "559-495-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3152 N MILLBROOK AVE",
            "address_2": "#SUITE B",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937031459",
            "telephone_number": "559-244-0133",
            "fax_number": "559-244-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "WADE",
        "middle_name": "ALDEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "A62554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAL STATE LIC NUMBER",
            "identifier": "A62554",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynda Margaret Dickerson Khouzam, M.D.
• Jordan Dickerson
• Melissa J Dickerson
• Nancy S. Dickerson, CRNA
• Judith Ann Dickey, LMFT
• Nickolas James Dicks
• Riley Dickson
• Susan Joanne Dickson
• Jemarie Austria Dictado
• Charles Keith Diddy, DDS

• Gynecology Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2013; 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.