JONATHAN ERIC WICKISER MD
NPI 1194740688
Pediatrics - Pediatric Hematology-Oncology in Dallas, TX

Q: What is Jonathan Wickiser's NPI number?

The NPI number for Jonathan Wickiser is 1194740688. It was assigned to this individual provider in the NPPES registry on July 13, 2006.

Q: What is Jonathan Wickiser's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Wickiser was last updated on April 24, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 13, 2006PECOS EnrolledAccepts Medicare Assignment

74.59/100

CMS Quality Rating

5323 HARRY HINES BLVD, DALLAS, TX 75390(214) 730-5437 Get Directions Write a Review

NPPES record last updated: April 24, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Jonathan Eric Wickiser Md NPPES

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

JONATHAN ERIC WICKISER MD (NPI 1194740688) is an individual pediatric hematology-oncology provider in Dallas, Texas, licensed in Texas (M4653) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Texas Tech University Health Science Center School Of Medicine (1999).

NPPES Registry Identity

NPI1194740688

Entity TypeIndividualMale

Primary Taxonomy2080P0207X

Provider Legal NameJONATHAN ERIC WICKISERCredential: MD

Location Address5323 HARRY HINES BLVDDallas, TX 75390-7201

Mailing AddressPo Box 845347Dallas, TX 75284-5347 · (214) 730-5437

Phone(214) 730-5437

Sole ProprietorNo

Medical School CMSTexas Tech University Health Science Center School Of MedicineGraduated 1999

Enumeration DateJuly 13, 2006

Last NPPES UpdateApril 24, 2012

✔ NPI 1194740688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Hematology-OncologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0207X

License✔ Licensed in TX · M4653

Definition

A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.

Also ListedPediatricsTaxonomy 208000000X · License M4653 (TX)

5323 HARRY HINES BLVD, Dallas, TX 75390

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas.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

Jonathan Eric Wickiser 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 ID2769488014

PECOS Enrollment IDI20061010000812

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

74.59/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

56.12

Promoting Interoperability

100

Improvement Activities

Cost

59.2

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.

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