Anceslo Idicula, MD

Primary specialty

Surgery of the Hand (Surgery) PhysicianTaxonomy code 2086S0105X

License

U5988 Issued in TX

Practice address

3601 4TH St # Ms 8312
Lubbock, TX 79430-0002

Phone

(806) 743-2373

Fax

(806) 743-4354

NPI assigned

May 11, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Hand Surgery

Education

Texas Tech University Health Science Center School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Tech University Health Sciences Center LubbockGroup PAC ID 4385549674, 363 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Medical Center Hospital, Lubbock, TX, CCN 450686

Merit-based Incentive Payment System (MIPS)

Final score

99.52 of 100Reported as apm

Quality

87.98

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anceslo.idicula@direct.myteamcare.com

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.

• Texas Tech University Health Sciences Center Lubbock

  • Anatomic Pathology Physician
  • Lubbock, TX
  • NPI 1063461358
  Medicare reassignment Care Compare group NPD
• Texas Tech University Health Sciences Center Lubbock

  • Durable Medical Equipment & Medical Supplies
  • Lubbock, TX
  • NPI 1053458026
  NPD
• Texas Tech University Health Sciences Center Lubbock

  • Orthopaedic Surgery Physician
  • Lubbock, TX
  • NPI 1245289537
  NPD
• Texas Tech University Health Sciences Center Lubbock

  • Anesthesiology Physician
  • Lubbock, TX
  • NPI 1306894175
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lubbock County Hospital District

  • Land Ambulance
  • Lubbock, TX
  • NPI 1174620546

  Hospital

  Care Compare affiliation
• Lubbock County Hospital District

  • Ambulatory Surgical Clinic/Center
  • Lubbock, TX
  • NPI 1538245717

  Hospital

  Care Compare affiliation
• Lubbock County Hospital District

  • Community/Retail Pharmacy
  • Lubbock, TX
  • NPI 1679521652

  Hospital

  Care Compare affiliation
• Lubbock County Hospital District

  • General Acute Care Hospital
  • Lubbock, TX
  • NPI 1821087164
  Care Compare affiliation
• Lubbock County Hospital District

  • Hearing and Speech Clinic/Center
  • Lubbock, TX
  • NPI 1831299114

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1528446572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 4TH ST # MS 8312",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-2373",
            "fax_number": "806-743-4354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST # MS 8312",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-2373",
            "fax_number": "806-743-4354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDICULA",
        "first_name": "ANCESLO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-11",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "BP10052704",
            "primary": false
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "TX",
            "license": "U5988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Hyman, LPC
• John Iacuone, M.D.
• Kyshondra Ibarra
• Yasin Ibrahim
• Roberto Hwang Ico, P.T.
• Kassie Idicula, PA
• Winslo K Idicula, M.D.
• Usiakimi Igbaseimokumo, MBBS, FRCS(C), MD
• Andrew Igbokwe, DO
• Igneous Dental PLLC

• Surgery of the Hand (Surgery) Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Surgery of the Hand (Surgery) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.