Mariaregina Landicho Wicks, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

00023369 Issued in WA

Practice address

Naval Health Clinic Oak Harbor 3475 No Saratoga St
Oak Harbor, WA 98278-0001

Phone

(360) 257-9501

Fax

(360) 257-9978

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Dr. Gina Landicho Wicks Professional name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1316025356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL HEALTH CLINIC OAK HARBOR 3475 NO SARATOGA ST",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982780001",
            "telephone_number": "360-257-9501",
            "fax_number": "360-257-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HEALTH CLINIC OAK HARBOR 3475 NO SARATOGA ST",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982780001",
            "telephone_number": "360-257-9501",
            "fax_number": "360-257-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKS",
        "first_name": "MARIAREGINA",
        "middle_name": "LANDICHO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "00023369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8176398",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA MD LICENSE",
            "identifier": "00023369",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES ID",
            "identifier": "170322",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UPIN",
            "identifier": "E47294",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS (PAYABLE GROUP)",
            "identifier": "7116841",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN (PTAN)",
            "identifier": "GAB38763",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "LANDICHO WICKS",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Robbin Lynn White, RN
• Robyn White, DNP
• Beecher C Whiteaker III
• Kelli Lynn Whiteaker, LMFTA
• Dione Whitley
• Alice Widdison
• Christopher J Wiegenstein, MS, LMHC, CDP
• Laura Wierleski
• Dianna Lynn Wilcox
• Hazel Marie Wilkison

• Family Medicine Physician in Oak Harbor, WA
• Providers in Oak Harbor, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.