NPIMap

Individual provider Active NPI

Amy M Wickman, MD

  • Orthopaedic Surgery Physician
  • Santa Barbara, CA
National Provider Identifier
1659532505
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A116979 Issued in CA
Practice address
511 Bath St
Santa Barbara, CA 93101
Phone
(805) 963-9377
Fax
(805) 962-2154
NPI assigned
Jun 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 125-049292 IL
Orthopaedic Surgery of the Spine Physician 207XS0117X 256809 NY
Orthopaedic Surgery Physician 207X00000X A116979 CA Primary

Addresses

Primary practice location

511 Bath St
Santa Barbara, CA 93101

Mailing address

511 Bath St
Santa Barbara, CA 93101
Phone (805) 963-9377

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
I20110815000706 CA Practitioner - Orthopedic Surgery 2860661568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Loyola University of Chicago, Stritch School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alta Orthopaedic Medical Group IncGroup PAC ID 7315837788, 22 clinicians

Practice addresses (Care Compare)

511 Bath St
Santa Barbara, CA 93101-3403
Phone (805) 963-9377

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.44 of 100Reported as individual
Quality
36.09
Promoting interoperability
93
Improvement activities
40
Cost
81.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion220
Laminectomy or laminotomy (partial removal of spine bones)123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A116979CAMDOrthopaedic Surgery Physician
125-049292ILMDOrthopaedic Surgery Physician
256809NYMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alta Orthopaedic Medical Group, Inc. Orthopaedic Surgery CurrentSince Sep 1, 2011 Accepting new patients
Alta Orthopaedic Medical Group Inc Orthopaedic Surgery CurrentSince Sep 1, 2011 Accepting new patients
Santa Ynez Valley Cottage Hospital, Inc Past Accepting new patients
Sansum Clinic Past Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients
Goleta Valley Cottage Hospital Past Accepting new patients

Locations

511 Bath St
Santa Barbara, CA 93101
Phone (805) 963-9377

510 Castillo St
Ste 203
Santa Barbara, CA 93101

2011 S Broadway
Ste N
Santa Maria, CA 93454
Phone (805) 440-9318

210 S Palisade Dr
Ste 201A
Santa Maria, CA 93454

2027 Village Ln
Ste 101
Solvang, CA 93463
Phone (805) 279-5579

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1272/brand/1/csg/1/fhir/r4
  • Direct secure messaging: amy.wickman.1@1272.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1659532505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 BATH ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "93101",
            "telephone_number": "805-963-9377",
            "fax_number": "805-962-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 BATH ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "93101",
            "telephone_number": "805-963-9377",
            "fax_number": "805-962-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKMAN",
        "first_name": "AMY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "125-049292",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NY",
            "license": "256809",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A116979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.