NPIMap

Individual provider Active NPI

Ryan Wicks, MD

  • Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1477874394
Registry record updated Jul 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
27805 Issued in OK
Practice address
3433 NW 56TH Street
Suite 900
Oklahoma City, OK 73112-4452
Phone
(405) 713-9935
Fax
(405) 713-9936
NPI assigned
Jun 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2017

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 27805 OK Primary

Addresses

Primary practice location

3433 NW 56TH Street
Suite 900
Oklahoma City, OK 73112-4452

Mailing address

5300 N Independence Ave
Suite 280
Oklahoma City, OK 73112-5556
Phone (405) 713-9935

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150721000908 OK Practitioner - General Surgery 6608189535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Oklahoma College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3366 NW Expressway
Suite 800
Oklahoma City, OK 73112-4458
Phone (405) 713-9935

3366 NW Expwy
Suite 800
Oklahoma City, OK 73112-4458

3400 NW Expressway
Suite 500
Oklahoma City, OK 73112-4492
Phone (405) 945-4589

5501 N Portland
Select Specialty Hosp West
Oklahoma City, OK 73112-2074
Phone (405) 951-4016

Hospital & facility affiliations

  • Integris Home Care Oklahoma City Home health agency, Oklahoma City, OK, CCN 377051
  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
  • Integris Health Edmond Hospital Hospital, Edmond, OK, CCN 370236
  • Integris Health Enid Hospital Hospital, Enid, OK, CCN 370016
  • St Mary'S Regional Medical Center Hospital, Enid, OK, CCN 370026
  • Stillwater Medical Center Hospital, Stillwater, OK, CCN 370049

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)22
Upper gastrointestinal (GI) endoscopy for acid reflux18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27805OKMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation CurrentSince Jul 29, 2015 Accepting new patients
Summit Medical Center Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Integris Baptist Medical Center Inc Past Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients

Locations

3366 NW Expressway St
Ste 800
Oklahoma City, OK 73112
Phone (405) 713-9935

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

3433 NW 56th St
Ste 900
Oklahoma City, OK 73112
Phone (405) 552-0401

Interoperability endpoints

  • Direct secure messaging: rwicks15109@direct.integrisok.com
  • Direct secure messaging: ryan.wicks.1@17407.direct.athenahealth.com

Organizations & group practices 5

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 9

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": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500508800000",
    "number": "1477874394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "SUITE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-713-9935",
            "fax_number": "405-713-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 NW 56TH STREET",
            "address_2": "SUITE 900",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124452",
            "telephone_number": "405-713-9935",
            "fax_number": "405-713-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKS",
        "first_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-15",
        "last_updated": "2017-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "27805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.