Active NPI
Elaina Wickman, PA
- Physician Assistant
- Shenandoah, TX
National Provider Identifier
1134519226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 134 Vision Park Blvd Ste 100
Shenandoah, TX 77384-3030 - Phone
- (936) 242-1437
- NPI assigned
- Jan 28, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | TX | Primary |
Addresses
Primary practice location
134 Vision Park Blvd Ste 100
Shenandoah, TX 77384-3030
Mailing address
17450 St Lukes Way Ste 390
The Woodlands, TX 77384-2001
Phone (936) 242-1437
Other practice location 1
9851 Fm 1097 Rd W Ste 110
Willis, TX 77318-5852
Phone (936) 228-7670
Other names 1
- Elaina McHenry
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Baylor College of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
20639 Kuykendahl Rd
Suite 200
Spring, TX 77379-3587
Phone (832) 698-0111
6767 Lake Woodlands Dr
The Woodlands, TX 77382-2566
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.05 of 100
- Quality
- 67.43
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 69.42
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2489 | SC | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Physician Services | Past | Accepting new patients | |
| Sterling Ridge Orthopaedics and Sports Medicine, LLC | Past | Accepting new patients |
Interoperability endpoints
- elaina.wickman.1@1066.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Sports Medicine (Orthopaedic Surgery) Physician
- The Woodlands, TX
- NPI 1881626117
-
- Orthopaedic Surgery Physician
- Austin, TX
- NPI 1952580425
-
- Radiology Clinic/Center
- Greenville, SC
- NPI 1720471618
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Houston, TX
- NPI 1730132234
-
- General Acute Care Hospital
- Tomball, TX
- NPI 1750819025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670976000000",
"number": "1134519226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17450 ST LUKES WAY STE 390",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773842001",
"telephone_number": "936-242-1437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134 VISION PARK BLVD STE 100",
"city": "SHENANDOAH",
"state": "TX",
"postal_code": "773843030",
"telephone_number": "936-242-1437"
}
],
"practiceLocations": [
{
"address_1": "9851 Fm 1097 Rd W Ste 110",
"address_purpose": "LOCATION",
"city": "Willis",
"state": "TX",
"postal_code": "773185852",
"country_code": "US",
"telephone_number": "936-228-7670",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WICKMAN",
"first_name": "ELAINA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-28",
"last_updated": "2022-12-14",
"certification_date": "2022-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELAINA",
"last_name": "MCHENRY",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Shenandoah, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.