Individual provider Active NPI

Richard Wick, M.D.

  • Anesthesiology Physician
  • Walla Walla, WA
National Provider Identifier
1285990929
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD60629016 Issued in WA
Practice address
401 W Poplar St
Walla Walla, WA 99362-2846
Phone
(509) 522-5174
NPI assigned
Apr 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X MD60629016 WA Primary

Addresses

Primary practice location

401 W Poplar St
Walla Walla, WA 99362-2846

Mailing address

PO Box 94645
Seattle, WA 98124-6945
Phone (509) 474-2072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160513000763 WA Practitioner - Anesthesiology 9032364591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Creighton University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Service- WashingtonGroup PAC ID 0840279758, 170 clinicians

Practice addresses (Care Compare)

401 W Poplar St
Walla Walla, WA 99362-2846
Phone (509) 897-3320

Hospital & facility affiliations

  • Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002

Merit-based Incentive Payment System (MIPS)

Final score
85.73 of 100Reported as group
Quality
83.21
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Service- Washington Anesthesiology CurrentSince Jun 15, 2016 Accepting new patients

Locations

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

401 W Poplar St
Walla Walla, WA 99362
Phone (509) 522-5731

Organizations & group practices 1

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": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1285990929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94645",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981246945",
            "telephone_number": "509-474-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W POPLAR ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622846",
            "telephone_number": "509-522-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICK",
        "first_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-06",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD60629016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

Verify at the official NPI Registry.