NPIMap

Individual provider Active NPI

Andrew Mark Wilke, M.D.

  • Emergency Medicine Physician
  • Las Cruces, NM
National Provider Identifier
1124086947
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
00025941 Issued in AL
Practice address
1930 Myrtle Ave
Las Cruces, NM 88001-5284
Phone
(505) 680-8226
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 00025941 AL Primary

Addresses

Primary practice location

1930 Myrtle Ave
Las Cruces, NM 88001-5284

Mailing address

1930 Myrtle Ave
Las Cruces, NM 88001-5284
Phone (505) 680-8226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240408001501 CA Practitioner - Emergency Medicine 6305733585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Wisconsin School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Redwood Medical Group IncGroup PAC ID 5496652703, 58 clinicians

Practice addresses (Care Compare)

275 Hospital Dr
Ukiah, CA 95482-4531
Phone (707) 462-3111

Hospital & facility affiliations

  • Adventist Health Mendocino Coast Hospital, Fort Bragg, CA, CCN 051325
  • Adventist Health Howard Memorial Hospital, Willits, CA, CCN 051310

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
73.31
Promoting interoperability
92
Improvement activities
40
Cost
62

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.76
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.41 of 100Reported as group
Quality
86.32
Promoting interoperability
95
Improvement activities
40
Cost
66.55

Merit-based Incentive Payment System (MIPS)

Final score
87.84 of 100Reported as group
Quality
86.21
Promoting interoperability
100
Improvement activities
40
Cost
73.25

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00025941ALMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Redwood Medical Group Inc Emergency Medicine CurrentSince Mar 1, 2024 Accepting new patients
Sierra Vista Hospital Past Accepting new patients
Buhari & Deguzman, Inc. a Med Corp Past Accepting new patients
Pacific County Hospital District 2 Past Accepting new patients
Sierra Vista Hospital Past Accepting new patients
California Em-I Medical Services, a Medical Corporation Emergency Medicine Past Accepting new patients
Sedro Woolley Emergency Physicians Emergency Medicine Past Accepting new patients
Mobile Emergency Group PC Emergency Medicine Past Accepting new patients
Washington Em-I Medical Services PC Emergency Medicine Past Accepting new patients
Pacific County Hospital District 2 PastSince Aug 1, 2012 Accepting new patients

Locations

15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820

700 River Dr
Fort Bragg, CA 95437
Phone (707) 961-1234

10 Woodland Rd
Saint Helena, CA 94574
Phone (707) 963-2002

275 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-7900

1 Marcela Dr
Willits, CA 95490
Phone (707) 456-3001

Organizations & group practices 10

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 2

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124086947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 MYRTLE AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880015284",
            "telephone_number": "505-680-8226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 MYRTLE AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880015284",
            "telephone_number": "505-680-8226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKE",
        "first_name": "ANDREW",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "00025941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.