ALVAH TYSON WICKBOLDT JR. M.D.
NPI 1083971006
Pain Medicine - Pain Medicine in New Orleans, LA

Q: What is Alvah Wickboldt's NPI number?

The NPI number for Alvah Wickboldt is 1083971006. It was assigned to this individual provider in the NPPES registry on April 15, 2012.

Q: What is Alvah Wickboldt's specialty?

The primary specialty registered for this NPI is Pain Medicine with taxonomy code 208VP0000X.

Q: When was this NPI record last updated?

The NPPES record for Alvah Wickboldt was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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 15, 2012PECOS EnrolledAccepts Medicare Assignment

1514 JEFFERSON HWY, BRENT HOUSE ROOM 634, NEW ORLEANS, LA 70121(504) 842-3000 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Aug 24, 2017 (2 updates tracked since 2017).

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About Alvah Tyson Wickboldt Jr. M.d. NPPES

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

ALVAH TYSON WICKBOLDT JR. M.D. (NPI 1083971006) is an individual pain medicine provider in New Orleans, Louisiana, licensed in Louisiana (305062) and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS and is a graduate of Louisiana State University School Of Medicine In New Orleans (2012).

NPPES Registry Identity

NPI1083971006

Entity TypeIndividualMale

Primary Taxonomy208VP0000X

Provider Legal NameALVAH TYSON WICKBOLDT JR.Credential: M.D.

Location Address1514 JEFFERSON HWY, BRENT HOUSE ROOM 634New Orleans, LA 70121-2429

Mailing Address1514 Jefferson HighwayNew Orleans, LA 70121-2429 · (504) 842-3000

Phone(504) 842-3000

Sole ProprietorNo

Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 2012

Enumeration DateApril 15, 2012

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1083971006 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPain Medicine · Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code208VP0000X

License✔ Licensed in LA · 305062

Definition

Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient's pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1514 JEFFERSON HWY, New Orleans, LA 70121

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Alvah Tyson Wickboldt Jr. M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103147772

PECOS Enrollment IDI20170919003489

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 70121 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

$128.88 typical visit price

range $55.50 – $170.30

Typical copayment $32.22 (range $13.87 – $42.57)

Most-billed visit code 99204

Established Patient

$98.35 typical visit price

range $17.42 – $138.03

Typical copayment $24.58 (range $4.35 – $34.50)

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. WALTER JORDAN HOYT JR. M.D.

Internal Medicine (Clinical Cardiac Electrophysiology)