Bryce Wikfors, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-996 Issued in ID

Practice address

206 E Elm St
Caldwell, ID 83605-4815

Phone

(208) 459-4511

NPI assigned

Sep 21, 2012

Last updated

Feb 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bryce.wikfors@1488.chartlogic.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Petrie White Family Medicine of Idaho

  dba Emmett Family Medicine and Direct Primary Care

  • Family Medicine Physician
  • Emmett, ID
  • NPI 1447629555
  NPD (past)
• Richard Lochhead MD PLLC

  • Neurological Surgery Physician
  • Boise, ID
  • NPI 1588063168
  NPD (past)

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

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1588915292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 E ELM ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 E ELM ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054815",
            "telephone_number": "208-459-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIKFORS",
        "first_name": "BRYCE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-21",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-996",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• White Willow Massage
• Ashley Fae White, NP
• Kayla White, LPC
• Savannah M Whiting, DO
• Stanton D Widmer, D.D.S.
• Michael E Wiley, LCSW
• Williams and Uralde Inc.
• Angela Marie Williams
• Delanie W Williamson, MED
• Jason Williamson

• Physician Assistant in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.