Individual provider Active NPI

Andrew Nadir Wickwire, PA-C

  • Physician Assistant
  • Fresno, CA
National Provider Identifier
1982115275
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8552 Issued in WI
Practice address
255 N Herwaldt Dr
Fresno, CA 93701-2186
Phone
(866) 342-6012
NPI assigned
Oct 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 55075 CA
Surgical Physician Assistant 363AS0400X 55075 CA
Physician Assistant 363A00000X 8552 WI Primary

Addresses

Primary practice location

255 N Herwaldt Dr
Fresno, CA 93701-2186

Mailing address

2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 443-2682

Other practice location 1

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 459-3770

Other practice location 2

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171120002006 CA Practitioner - Physician Assistant 6406113828 Reassigns benefits to 1 organization
I20250911004910 WI Practitioner - Physician Assistant 6406113828 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Hospital & facility affiliations

  • Marshfield Medical Center Hospital, Marshfield, WI, CCN 520037

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as group
Quality
76.71
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
55075CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Sep 8, 2025 Accepting new patients
Flambeau Hospital Inc CurrentSince Sep 8, 2025 Accepting new patients
University Faculty Associates, Inc. CurrentSince Nov 10, 2017 Accepting new patients
Memorial Hospital Inc CurrentSince Sep 8, 2025 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Sep 8, 2025 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Sep 8, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Sep 8, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Sep 8, 2025 Accepting new patients
Marshfield Clinic Inc CurrentSince Sep 8, 2025 Accepting new patients
Flambeau Hospital Inc CurrentSince Sep 8, 2025 Accepting new patients

Locations

2335 E Kashian Ln
Ste 240
Fresno, CA 93701
Phone (559) 320-0545

255 N Herwaldt Dr
Fresno, CA 93701
Phone (559) 459-7300

2335 E Kashian Ln
Ste 410
Fresno, CA 93701
Phone (559) 266-4100

2625 E Divisadero St
Fresno, CA 93721
Phone (559) 453-5200

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Organizations & group practices 10

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1982115275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431",
            "telephone_number": "559-443-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N HERWALDT DR",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012186",
            "telephone_number": "866-342-6012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2823 Fresno St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937211324",
            "country_code": "US",
            "telephone_number": "559-459-3770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 N Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "544495703",
            "country_code": "US",
            "telephone_number": "715-387-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICKWIRE",
        "first_name": "ANDREW",
        "middle_name": "NADIR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-13",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55075",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "55075",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "8552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.