Individual provider Active NPI

Eric D Wicks, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Lakeland, FL
National Provider Identifier
1184787228
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
ME118027 Issued in FL
Practice address
3030 Harden Blvd
Lakeland, FL 33803
Phone
(863) 687-1250
Fax
(863) 687-1258
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9310 FL
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X ME118027 FL Primary

Addresses

Primary practice location

3030 Harden Blvd
Lakeland, FL 33803

Mailing address

1324 Lakeland Hills BLV.D
Attn: Managed Care Dept.
Lakeland, FL 33805

Other practice location 1

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1321

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ewicks18511@LRHS.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070126000420 FL Practitioner - Orthopedic SurgeryPractitioner - Sports MedicinePractitioner - Chiropractic 7719988146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Northeastern Ohio University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

3030 Harden Blvd
Lakeland, FL 33803-7952
Phone (863) 284-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.12 of 100Reported as group
Quality
64.08
Promoting interoperability
98
Improvement activities
40
Cost
76.83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)12
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CH9310FLMDChiropractor
ME118027FLMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Regional Health Systems, Inc. CurrentSince Sep 1, 2018 Accepting new patients
Lakeland Regional Medical Center, Inc. Past Accepting new patients

Locations

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

3030 Harden Blvd
Lakeland, FL 33803
Phone (863) 687-1222

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: ewicks18511@lrhs.direct-ci.com

Organizations & group practices 2

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 1

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1184787228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLV.D",
            "address_2": "ATTN: MANAGED CARE DEPT.",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 HARDEN BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33803",
            "telephone_number": "863-687-1250",
            "fax_number": "863-687-1258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1324 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054543",
            "country_code": "US",
            "telephone_number": "863-687-1321",
            "fax_number": "863-687-1258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICKS",
        "first_name": "ERIC",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9310",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME118027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewicks18511@LRHS.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3030 Harden Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.