Richard P Wikholm, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G55811 Issued in CA

Practice address

116 S Palisade Dr
Ste 206
Santa Maria, CA 93454-8904

Phone

(805) 614-9250

Fax

(805) 614-9260

NPI assigned

Jul 14, 2005

Last updated

Oct 1, 2009By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Otolaryngology

Education

University of Texas Medical School at San Antonio, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Central Coast OtolaryngologyGroup PAC ID 2769521178, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107
• French Hospital Medical Center Hospital, San Luis Obispo, CA, CCN 050232

Merit-based Incentive Payment System (MIPS)

Final score

99.52 of 100Reported as group

Quality

92.51

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Central Coast Otolaryngology

  dba Sleep Disorders Center of Santa Maria

  • Otolaryngology Physician
  • Santa Maria, CA
  • NPI 1427382811
  Medicare reassignment Care Compare group NPD
• Central Coast Otolaryngology

  • Medical Specialty Clinic/Center
  • Santa Maria, CA
  • NPI 1043623960
  NPD Authorized official

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

• Dignity Community Care

  dba French Hospital Medical Center

  • General Acute Care Hospital
  • San Luis Obispo, CA
  • NPI 1881760452
  Care Compare affiliation
• Dignity Health

  • General Acute Care Hospital
  • Santa Maria, CA
  • NPI 1760510937
  Care Compare affiliation

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254355200000",
    "number": "1831198647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5427",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934565427",
            "telephone_number": "805-614-6250",
            "fax_number": "805-614-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S PALISADE DR",
            "address_2": "STE 206",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934548904",
            "telephone_number": "805-614-9250",
            "fax_number": "805-614-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIKHOLM",
        "first_name": "RICHARD",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2009-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G55811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G558110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debbie White, CDAC II-CA
• Jamie A White
• Karen White, RN, PHN
• John R. Wicks
• Kristine Gwen Wiesner, RN
• Amy Louise Wilborn, M.S.
• William R Reid OD Inc
• Aurora William
• Elyssa Shayne Williams
• Jordan Ryan Williams, PA-C

• Otolaryngology Physician in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; 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.