Danielle Anette Wickman, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A151112 Issued in CA

Practice address

1225 Wilshire Blvd
Los Angeles, CA 90017-1901

Phone

(213) 977-2121

NPI assigned

Apr 5, 2016

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

Electronic endpoints 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

Emergency Medicine

Education

University of California, Geffen School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Diego Emergency Physicians IncGroup PAC ID 1052771698, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100
• Temecula Valley Hospital Hospital, Temecula, CA, CCN 050775

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• San Diego Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1194429233
  Medicare reassignment Care Compare group NPD
• Chula Vista Emergency Room Physicians, a Medical Corporation

  • Emergency Medicine Physician
  • Chula Vista, CA
  • NPI 1780021782
  Medicare reassignment NPD
• Pinnacle Emergency Physicians of Bakersfield, a Professional Corp

  • Emergency Medicine Physician
  • Bakersfield, CA
  • NPI 1619153251
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Temecula Valley Emergency Physicians, Inc

  • Emergency Medicine Physician
  • Temecula, CA
  • NPI 1407281223
  Medicare reassignment NPD
• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306
  Medicare reassignment NPD
• Pinnacle Emergency Physicians of Bakersfield, a Professional Corp

  • Emergency Medicine Physician
  • Bakersfield, CA
  • NPI 1386980415
  NPD
• Pinnacle Emergency Physicians of Bakersfield, a Professional Corp

  • Emergency Medicine Physician
  • Bakersfield, CA
  • NPI 1639415862
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • San Diego, CA
  • NPI 1023425972
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Usc Care Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1427937390
  NPD

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

• Sharp Memorial Hospital

  • Rehabilitation Hospital Unit
  • San Diego, CA
  • NPI 1114901352
  Care Compare affiliation
• Sharp Memorial Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1407839921
  Care Compare affiliation
• Temecula Valley Hospital Inc

  • General Acute Care Hospital
  • Temecula, CA
  • NPI 1679816201
  Care Compare affiliation

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1962865063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "213-977-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171901",
            "telephone_number": "213-977-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKMAN",
        "first_name": "DANIELLE",
        "middle_name": "ANETTE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-05",
        "last_updated": "2023-10-27",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A151112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Zoe Wick, LMFT
• Kelly Lee Wickham
• Maria D Wickham, RPT
• Brianne Wickland, DPT
• Charles Wallace Wickliffe
• Thilini Wickramarachchi
• Nell Cathryn Wickstrom, AMFT
• Azzah Widatalla, DDS
• Jared Robert Widder, D.O.
• Stacey Lind Widger

• Emergency Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.