Brian E Wicker, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9105658 Issued in FL

Practice address

2352 Bruce B Downs Blvd Ste 102
Wesley Chapel, FL 33544-9203

Phone

(813) 979-0440

NPI assigned

Sep 21, 2010

Last updated

Jul 28, 2022By 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 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Florida Medical Clinic LLC

  • Clinic/Center
  • Zephyrhills, FL
  • NPI 1821055690
  Medicare reassignment NPD
• Ohi West Medical Group II LLC

  • General Practice Physician
  • Zephyrhills, FL
  • NPI 1982381299
  Medicare reassignment NPD
• Musculoskeletal Institute Chartered

  dba Florida Orthopaedic Institute

  • Orthopaedic Surgery Physician
  • Temple Terrace, FL
  • NPI 1386639920
  Medicare reassignment
• Florida Medical Clinic, LLC

  dba Florida Medical Clinic Pharmacy

  • Pharmacy
  • Zephyrhills, FL
  • NPI 1669548020
  NPD
• Musculoskeletal Institute Chartered

  dba Florida Orthopaedic Institute

  • Orthopaedic Surgery Physician
  • Brandon, FL
  • NPI 1225191729
  NPD
• Ohi West Medical Group II LLC

  dba Florida Medical Clinic Orlando Health

  • Durable Medical Equipment & Medical Supplies
  • Wesley Chapel, FL
  • NPI 1427814847
  NPD
• Putnam Physician Practices, LLC

  dba Putnam Orthopaedic Associates

  • Orthopaedic Surgery Physician
  • Palatka, FL
  • NPI 1780957944
  NPD (past)

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1932417235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQUARE DR",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "352-567-0188",
            "fax_number": "813-355-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2352 BRUCE B DOWNS BLVD STE 102",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335449203",
            "telephone_number": "813-979-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKER",
        "first_name": "BRIAN",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-21",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105658",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105658",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9105658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002748200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y05NE",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle White, MA, LMHC, LCPC
• Michelle Renee White
• Rachael E White, OTD, OTR/L, ATC, LAT
• Haley Whitmore
• Renelle Lian Whyte-Gunn, APRN-BC
• Sandra Wickham
• Eric P Widhson
• Johnny Wild, RDN
• Cleopatra Wilder, CSFA
• Beena Mathews Wilkins, M.D.

• Surgical Physician Assistant in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.