Kyle Raynor Wicomb

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A176702 Issued in CA

Practice address

7901 Broadway # A1-16
Elmhurst, NY 11373-1329

Phone

(718) 334-2488

NPI assigned

Mar 20, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI, CA2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

24 On Physicians of California PCGroup PAC ID 7012228992, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• El Centro Regional Medical Center Hospital, El Centro, CA, CCN 050045
• Pioneers Memorial Healthcare District Hospital, Brawley, CA, CCN 050342

Merit-based Incentive Payment System (MIPS)

Final score

84.87 of 100Reported as group

Quality

71.11

Improvement activities

40

Cost

69.18

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwicomb21755@hhsc.direct-ci.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.

• 24 On Physicians of California, PC

  • Hospitalist Physician
  • Porterville, CA
  • NPI 1730570565
  Medicare reassignment Care Compare group NPD
• Hawaii Post-Acute Medical Services 1 Inc

  • Hospitalist Physician
  • Hilo, HI
  • NPI 1780171074
  Medicare reassignment NPD
• Quantum Healthcare Medical Associates Inc.

  • Hospitalist Physician
  • Colton, CA
  • NPI 1568490597

  HI, Internal Medicine

  Medicare reassignment NPD
• Hilo Benioff Medical Center

  • General Acute Care Hospital
  • Hilo, HI
  • NPI 1780757856
  NPD (past)

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

• El Centro Regional Medical Center

  • General Acute Care Hospital
  • El Centro, CA
  • NPI 1861409823
  Care Compare affiliation
• Imperial Valley Healthcare District

  • General Acute Care Hospital
  • Brawley, CA
  • NPI 1184429185
  Care Compare affiliation

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1558865147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 N 10TH ST APT 3",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434462",
            "telephone_number": "808-747-6349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY # A1-16",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICOMB",
        "first_name": "KYLE",
        "middle_name": "RAYNOR",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-20",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A176702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Charles Wend, DO
• Marilyn Wender, SLP
• Rachel Wender, MS
• Jessica Wetzel, LMSW
• Judith White, NP
• Melia Widagdo-Wuntu, R.N.
• Sarah Wie
• Michelle Malesa Williams, NP
• Venaida Tonia Williams
• Melissa Wilson, RN

• Internal Medicine Physician in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.