Individual provider Active NPI

David J Wykstra, M.D.

  • Surgery Physician
  • Waycross, GA
National Provider Identifier
1285855148
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
055907 Issued in GA
Practice address
1908 Alice St
Waycross, GA 31501-6208
Phone
(912) 338-6010
Fax
(912) 287-2796
NPI assigned
May 1, 2007
Last updated
Mar 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 055907 GA Primary

Addresses

Primary practice location

1908 Alice St
Waycross, GA 31501-6208

Mailing address

1908 Alice St
Waycross, GA 31501-6208
Phone (912) 338-6010

Other identifiers 1

IdentifierTypeStateIssuer
655012398BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20070816000255 GA Practitioner - General Surgery 3476645771 Reassigns benefits to 2 organizations
Practice locations: Waycross, GA

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Georgia School of Medicine, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Memorial Satilla Specialists, LLCGroup PAC ID 5991074957, 19 clinicians

Practice addresses (Care Compare)

1900 Tebeau St
Waycross, GA 31501-6357
Phone (912) 283-3030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.02 of 100Reported as group
Quality
57.87
Promoting interoperability
100
Improvement activities
40
Cost
75.97

Merit-based Incentive Payment System (MIPS)

Final score
91.07 of 100Reported as group
Quality
81.4
Promoting interoperability
99
Improvement activities
40
Cost
71.99

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
055907GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Georgia Health Services, L.L.C. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: david.wykstra@hca5.eclinicaldirectplus.com
  • Direct secure messaging: david.wykstra@mhs.gadirect.net

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 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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1285855148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016208",
            "telephone_number": "912-338-6010",
            "fax_number": "912-287-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016208",
            "telephone_number": "912-338-6010",
            "fax_number": "912-287-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYKSTRA",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "055907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "655012398B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.