Cayla Wideman, PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

PA12634 Issued in TX

Practice address

1515 Holcombe Blvd
Houston, TX 77030-4000

Phone

(844) 723-1310

NPI assigned

Mar 1, 2019

Sex

Female

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 TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Referral ServiceGroup PAC ID 7911801410, 2,728 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Texas M D Anderson Cancer Center Hospital, Houston, TX, CCN 450076

Merit-based Incentive Payment System (MIPS)

Final score

84.29 of 100Reported as group

Quality

70.82

Promoting interoperability

100

Improvement activities

40

Cost

67.65

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: cwideman121102@utmdandersoncc.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.

• Physicians Referral Service

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1073574810
  Medicare reassignment Care Compare group

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

• University of Texas M. D. Anderson Cancer Center

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1174582050
  Care Compare affiliation

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551398400000",
    "number": "1629535281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8826 BRAEWICK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770747610",
            "telephone_number": "713-252-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304000",
            "telephone_number": "844-723-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDEMAN",
        "first_name": "CAYLA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-01",
        "last_updated": "2019-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "PA12634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keleigh Sue Wickersham
• Jennifer Wickesberg, AU.D.
• Sasrutha Rasika Wickramasinghe, M.D., PH.D.,
• Susan Eileen Wicks, LPC
• Brittany Lauren Widacki, OTR/L
• Cheryl Huntley Widen, OTR
• Andrew Widener
• Ashly Robert Wiebelt, M.S., CCC-SLP
• Catherine Elizabeth Wiechmann, MD
• Matthias Heinz Wiederholz, M.D.

• Surgery Physician in Houston, TX
• Providers in Houston, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; 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.