Individual provider Active NPI

Thomas Lee Wicks, DPM

  • Podiatrist
  • Chickasha, OK
National Provider Identifier
1265413694
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
239 Issued in OK
Practice address
2100 W Iowa Ave
Chickasha, OK 73018-2736
Phone
(405) 224-2100
Fax
(405) 779-2896
NPI assigned
Nov 11, 2005
Last updated
Aug 16, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 239 OK Primary

Addresses

Primary practice location

2100 W Iowa Ave
Chickasha, OK 73018-2736

Mailing address

2100 W Iowa Ave
Chickasha, OK 73018-2736
Phone (405) 224-2100

Other identifiers 1

IdentifierTypeStateIssuer
200029530AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040624001664 OK Practitioner - Podiatry 0648256396 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
University of Iowa, RJ & L Carver College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McAlester Medical Services LLCGroup PAC ID 9931139029, 21 clinicians

Practice addresses (Care Compare)

1 E Clark Bass Blvd
McAlester, OK 74501-4209
Phone (918) 421-6987

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue67
Removal of nail tissue26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McAlester Medical Services, LLC CurrentSince Feb 2, 2020 Accepting new patients
McAlester Regional Health Center Authority CurrentSince Apr 27, 2021 Accepting new patients
McAlester Ambulatory Surgery Center, LLC CurrentSince Sep 6, 2024 Accepting new patients

Locations

1 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6941

1 E Clark Bass Blvd
Ste 210
McAlester, OK 74501
Phone (918) 421-6753

4 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6700

Interoperability endpoints

  • Direct secure messaging: thomas.wicks@direct.mrhcok.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1265413694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W IOWA AVE",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730182736",
            "telephone_number": "405-224-2100",
            "fax_number": "405-779-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W IOWA AVE",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730182736",
            "telephone_number": "405-224-2100",
            "fax_number": "405-779-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKS",
        "first_name": "THOMAS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OK",
            "license": "239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200029530A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chickasha, OK

Sources for this page

Verify at the official NPI Registry.