Winslo K Idicula, M.D.

Primary specialty

Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X

License

R0023 Issued in TX

Practice address

3601 4TH Street Stop 9905
Lubbock, TX 79430-3153

Phone

(806) 743-3277

NPI assigned

Jul 22, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Otolaryngology

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Tech University Health Sciences Center LubbockGroup PAC ID 4385549674, 363 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Medical Center Hospital, Lubbock, TX, CCN 450686
• Covenant Medical Center Hospital, Lubbock, TX, CCN 450040

Merit-based Incentive Payment System (MIPS)

Final score

99.52 of 100Reported as apm

Quality

87.98

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: winslo.idicula@direct.myteamcare.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.

• Texas Tech University Health Sciences Center Lubbock

  • Anatomic Pathology Physician
  • Lubbock, TX
  • NPI 1063461358

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Texas Tech University Health Sciences Center Lubbock

  • Durable Medical Equipment & Medical Supplies
  • Lubbock, TX
  • NPI 1053458026
  NPD
• Texas Tech University Health Sciences Center Lubbock

  • Surgery Physician
  • Lubbock, TX
  • NPI 1508815895

  Single Specialty

  NPD
• Texas Tech University Health Sciences Center Lubbock

  • Anesthesiology Physician
  • Lubbock, TX
  • NPI 1306894175

  Single Specialty

  NPD (past)

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

• Covenant Medical Center

  • General Acute Care Hospital
  • Lubbock, TX
  • NPI 1972517365
  Care Compare affiliation
• Lubbock County Hospital District

  • Land Ambulance
  • Lubbock, TX
  • NPI 1174620546

  Hospital

  Care Compare affiliation
• Lubbock County Hospital District

  • Ambulatory Surgical Clinic/Center
  • Lubbock, TX
  • NPI 1538245717

  Hospital

  Care Compare affiliation
• Lubbock County Hospital District

  • Community/Retail Pharmacy
  • Lubbock, TX
  • NPI 1679521652

  Hospital

  Care Compare affiliation
• Lubbock County Hospital District

  • General Acute Care Hospital
  • Lubbock, TX
  • NPI 1821087164
  Care Compare affiliation
• Lubbock County Hospital District

  • Hearing and Speech Clinic/Center
  • Lubbock, TX
  • NPI 1831299114

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1851604573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 127TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79423",
            "telephone_number": "214-680-9624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH STREET STOP 9905",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794303153",
            "telephone_number": "806-743-3277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 Olentangy River Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432123153",
            "country_code": "US",
            "telephone_number": "614-293-9215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDICULA",
        "first_name": "WINSLO",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-22",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "57017666",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "TX",
            "license": "R0023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "winslo.idicula@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "3601 4th Street STOP 9905",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794303153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kyshondra Ibarra
• Yasin Ibrahim
• Roberto Hwang Ico, P.T.
• Anceslo Idicula, MD
• Kassie Idicula, PA
• Usiakimi Igbaseimokumo, MBBS, FRCS(C), MD
• Andrew Igbokwe, DO
• Igneous Dental PLLC
• Igor Siniakov, M.D., P.a.
• Dominique Iida

• Pediatric Otolaryngology Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Pediatric Otolaryngology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.
• 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.