NPIMap

Individual provider Active NPI

Wendy Wicke, PA-C

  • Physician Assistant
  • Sonora, CA
National Provider Identifier
1548685175
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
51439 Issued in CA
Practice address
1000 Greenley Rd
Sonora, CA 95370-5200
Phone
(209) 532-5000
NPI assigned
Feb 18, 2014
Last updated
Feb 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 51439 CA Primary

Addresses

Primary practice location

1000 Greenley Rd
Sonora, CA 95370-5200

Mailing address

PO Box 4685
Sonora, CA 95370-1685
Phone (209) 532-1326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150828000625 CA Practitioner - Physician Assistant 1456667930 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sierra Emergency Medical Group IncGroup PAC ID 2860542479, 24 clinicians

Practice addresses (Care Compare)

1000 Greenley Rd
Sonora, CA 95370-5200
Phone (209) 536-5000

14540 Mono Way
Sonora, CA 95370-8858
Phone (209) 536-6680

23 N Main St
Suite 101
Angels Camp, CA 95222-8001
Phone (209) 736-9130

729 Pauline Court
Sonora, CA 95370
Phone (209) 588-8068

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as group
Quality
90.55
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network CurrentSince Mar 12, 2024 Accepting new patients
Adventist Health Physicians Network CurrentSince Mar 12, 2024 Accepting new patients
Sonora Community Hospital CurrentSince Jun 27, 2015 Accepting new patients
Sonora Community Hospital CurrentSince Jun 27, 2015 Accepting new patients

Locations

1524 W Lacey Blvd
Ste 101
Hanford, CA 93230
Phone (559) 583-4695

1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803

14540 State Highway 108
Sonora, CA 95370
Phone (209) 532-3167

Interoperability endpoints

  • Direct secure messaging: wwicke@yourcarecommunity.org

Organizations & group practices 6

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 12

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": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1548685175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4685",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953701685",
            "telephone_number": "209-532-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GREENLEY RD",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705200",
            "telephone_number": "209-532-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKE",
        "first_name": "WENDY",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

Verify at the official NPI Registry.