Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MS. ELENA L WICKSTROM MD
NPI 1003497470
Emergency Medicine in Newark, NJ

Q: What is Elena Wickstrom's NPI number?

The NPI number for Elena Wickstrom is 1003497470. It was assigned to this individual provider in the NPPES registry on April 17, 2021.

Q: What is Elena Wickstrom's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Elena Wickstrom was last updated on October 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 27 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 17, 2021PECOS Enrolled

185 S ORANGE AVE, NEWARK, NJ 07103(732) 445-4636 Get Directions Write a Review

NPPES record last updated: October 6, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 6, 2026, Apr 17, 2021 (2 updates tracked since 2021).

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About Ms. Elena L Wickstrom Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. ELENA L WICKSTROM MD (NPI 1003497470) is an individual emergency medicine provider in Newark, New Jersey, licensed in Kansas (04-53637) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS, is affiliated with Saint John Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1003497470

Entity TypeIndividualFemale

Primary Taxonomy207P00000X

Provider Legal NameMS. ELENA L WICKSTROMCredential: MD

Location Address185 S ORANGE AVENewark, NJ 07103-2757

Mailing Address185 S Orange AveNewark, NJ 07103-2757 · (732) 445-4636

Phone(732) 445-4636

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateApril 17, 2021

Last NPPES UpdateOctober 6, 20262 updates tracked since enumeration

NPPES CertifiedOctober 6, 2026

✔ NPI 1003497470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in KS · 04-53637

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

185 S ORANGE AVE, Newark, NJ 07103

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Elena L Wickstrom Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5193286136

PECOS Enrollment IDI20260909004919

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint John Hospital

Acute Care Hospitals · Leavenworth, KS

OwnershipVoluntary non-profit - Other

CMS Certification Number170009

Location3500 South 4th StreetLeavenworth, KS 66048 · Leavenworth County

Emergency services

Providence Medical Center

Acute Care Hospitals · Kansas City, KS

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number170146

Location8929 Parallel ParkwayKansas City, KS 66112 · Wyandotte County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$98.09 typical visit price

range $63.84 – $190.92

Typical copayment $24.52 (range $15.96 – $47.73)

Most-billed visit code 99203

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DEEPA ASOKAN M.D.

Anesthesiology

185 S ORANGE AVE, MSB STE E547
NEWARK, NJ 07103

Essex County (973) 972-5006

LISSETTE MARIA CESPEDES M.D.

Internal Medicine (Endocrinology, Diabetes & Metabolism)

185 S ORANGE AVE, MSB I588
NEWARK, NJ 07103

Essex County (973) 972-3479

ALEXANDRA M. SELBERG

Student in an Organized Health Care Education/Training Program

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (973) 972-5018

CHEYNYA JOHNSON-BRIMLEY PA-C

Physician Assistant (Medical)

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (848) 445-4636

KIRSYS GUERRERO FUENTES MD

Student in an Organized Health Care Education/Training Program

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (646) 640-6429

SAGAR PATEL

Student in an Organized Health Care Education/Training Program

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (973) 972-6049

DR. EVANIE ANGLADE MD

Student in an Organized Health Care Education/Training Program

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (973) 972-6049

CARMA HELEN GOLDSTEIN

Surgery

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (973) 972-4417

SRUTHI REDDY GOHIMUKKULA MD

Student in an Organized Health Care Education/Training Program

185 S ORANGE AVE, MSB E-506
NEWARK, NJ 07103

Essex County (973) 972-3574

ADEENA SAMONI

Anesthesiology

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (973) 972-0470

BENJAMIN PARK

Student in an Organized Health Care Education/Training Program

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (973) 972-4823

MISS KATHERINE LEE LAURITSEN MD

Student in an Organized Health Care Education/Training Program

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (973) 972-6049

DAN CHEN MD

Anesthesiology

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (973) 972-5007

ADAM N FANO

Student in an Organized Health Care Education/Training Program

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (973) 580-1948

JENNYFER YANEIRI VILLAVICENCIO

Student in an Organized Health Care Education/Training Program

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (848) 469-6577

DR. AMAN M PATEL MD

Student in an Organized Health Care Education/Training Program

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (973) 972-4300

DR. AZIZ M MERCHANT MD

Surgery

185 S ORANGE AVE, RUTGERS-NEW JERSEY MEDICAL SCHOOL, MSB G514
NEWARK, NJ 07103

Essex County (973) 972-0072

NIVETHA SRINIVASAN MD

Student in an Organized Health Care Education/Training Program

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (732) 445-4636

SRIKAR DONEPUDI

Student in an Organized Health Care Education/Training Program

185 S ORANGE AVE
NEWARK, NJ 07103

Essex County (732) 445-4636

ALICE SHAPIRO

Obstetrics & Gynecology

185 S ORANGE AVE, E-105
NEWARK, NJ 07103

Essex County (973) 972-5266

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elena Wickstrom's NPI number?

The NPI number for Elena Wickstrom is 1003497470. It was assigned to this individual provider in the NPPES registry on April 17, 2021.

Where is Elena Wickstrom located?

Elena Wickstrom practices at 185 S Orange Ave, Newark, NJ 07103. The listed phone number is (732) 445-4636.

What is Elena Wickstrom's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Elena Wickstrom enrolled in Medicare?

Yes. Elena Wickstrom is registered in the Medicare PECOS enrollment system.

Is Elena Wickstrom affiliated with any hospitals?

According to CMS data, Elena Wickstrom is affiliated with Saint John Hospital and Providence Medical Center.

When was this NPI record last updated?

The NPPES record for Elena Wickstrom was last updated on October 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 27 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.