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IVY WICKS MD
NPI 1093247769
Family Medicine in Waldorf, MD

Active since March 31, 2017PECOS EnrolledAccepts Medicare Assignment
12070 OLD LINE CTR STE 302, WALDORF, MD 20602(301) 645-6667(301) 870-9722 Get Directions Write a Review

NPPES record last updated: June 5, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 5, 2026, Jun 24, 2021, Mar 31, 2017 (3 updates tracked since 2017).

About Ivy Wicks Md NPPES

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

IVY WICKS MD (NPI 1093247769) is an individual family medicine provider in Waldorf, Maryland, licensed in Maryland (D0091620) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS and is a graduate of Meharry Medical College School Of Medicine (2017).

NPPES Registry Identity

NPI1093247769
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameIVY WICKSCredential: MD
Location Address12070 OLD LINE CTR STE 302Waldorf, MD 20602-2567
Mailing Address12070 Old Line Ctr Ste 302Waldorf, MD 20602-2567 · (301) 645-6667 · Fax (301) 870-9722
Phone(301) 645-6667
Fax(301) 870-9722
Sole ProprietorNo
Medical School CMSMeharry Medical College School Of MedicineGraduated 2017
Enumeration DateMarch 31, 2017
Last NPPES UpdateJune 5, 20263 updates tracked since enumeration
NPPES CertifiedJune 5, 2026
✔ NPI 1093247769 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MD · D0091620
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
12070 OLD LINE CTR STE 302, Waldorf, MD 20602
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Other Names 1

Other Name (5)Ivy Chantal Williams Md

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

Ivy Wicks Md 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 ID2163786690
PECOS Enrollment IDI20230811003064
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
23 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20602 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
$89.75 typical visit price
range $57.99 – $175.57
Typical copayment $22.43 (range $14.49 – $43.89)
Most-billed visit code 99203
Established Patient
$102.11 typical visit price
range $18.66 – $143.02
Typical copayment $25.52 (range $4.66 – $35.75)
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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers12 claims32 services$6.86 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$89.64 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$34.91 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

PRIVIA MEDICAL GROUP, LLC
Family Medicine
12070 OLD LINE CTR STE 302
WALDORF, MD 20602
Charles County (301) 843-7667

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 Ivy Wicks's NPI number?

The NPI number for Ivy Wicks is 1093247769. It was assigned to this individual provider in the NPPES registry on March 31, 2017. The provider is also known as Ivy Chantal Williams MD.

Where is Ivy Wicks located?

Ivy Wicks practices at 12070 Old Line Ctr Ste 302, Waldorf, MD 20602. The listed phone number is (301) 645-6667.

What is Ivy Wicks's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Ivy Wicks enrolled in Medicare?

Yes. Ivy Wicks is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Ivy Wicks was last updated on June 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 60 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.