Gregory Mathew Wickern, M.D.

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

M-10495 Issued in ID

Practice address

1502 Locust St N Ste 600
Twin Falls, ID 83301-4164

Phone

(208) 734-6091

Fax

(208) 734-4654

NPI assigned

Feb 17, 2006

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

Medicare fee-for-service enrollment

Enrolled in ID, NV2 enrollments

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 2

Specialty

Allergy/ImmunologyAlso: Pediatric Medicine

Education

Uniformed Services Uhs Fe Hebert School of Med, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Asthma and Allergy of Idaho PLLCGroup PAC ID 7416943782, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002

Merit-based Incentive Payment System (MIPS)

Final score

88.42 of 100Reported as group

Quality

100

Improvement activities

40

Cost

61.41

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.

• Asthma & Allergy of Idaho PLLC

  • Allergy Physician
  • Twin Falls, ID
  • NPI 1427138734

  NV

  Medicare reassignment Care Compare group
• Asthma & Allergy of Idaho

  • Nurse Practitioner
  • Twin Falls, ID
  • NPI 1265635171
  NPD

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

• St. Luke'S Magic Valley Regional Medical Center, LTD.

  • General Acute Care Hospital
  • Twin Falls, ID
  • NPI 1932154705
  Care Compare affiliation

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1972578672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FALLS AVE",
            "address_2": "SUITE #2",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013366",
            "telephone_number": "208-734-6091",
            "fax_number": "208-734-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 LOCUST ST N STE 600",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014164",
            "telephone_number": "208-734-6091",
            "fax_number": "208-734-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKERN",
        "first_name": "GREGORY",
        "middle_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NV",
            "license": "13018",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "UT",
            "license": "6578473-1205",
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "ID",
            "license": "M-10495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Montana James White, NP
• Julie Ann Whitehead, MS, CCC/SLP, L
• Michael Robert Whitehead, PH.D., LMFT
• Jessea Camille Whitlow, PA-C
• Lani B. Whitney, LPC
• Kim Cheri Wiggins, M.D.
• Deena Michelle Wiley-Vegwert, MS
• Wilhelm Chiropractic LLC
• Cody Wilhelm, DC
• Jacob Jeremiah Wilkins

• Allergy Physician in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Allergy Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.