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

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.

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
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

Accepted 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
Quality56.12
Promoting Interoperability100
Improvement Activities40
Cost59.2

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.

Anesthesiology
5323 HARRY HINES BLVD
DALLAS, TX 75390
Obstetrics & Gynecology (Maternal & Fetal Medicine)
5323 HARRY HINES BLVD
DALLAS, TX 75390
Radiology (Diagnostic Radiology)
5323 HARRY HINES BLVD
DALLAS, TX 75390
Pathology (Anatomic Pathology & Clinical Pathology)
5323 HARRY HINES BLVD
DALLAS, TX 75390
Genetic Counselor, MS
5323 HARRY HINES BLVD
DALLAS, TX 75390
Pathology (Immunopathology)
5323 HARRY HINES BLVD
DALLAS, TX 75390
Internal Medicine
5323 HARRY HINES BLVD
DALLAS, TX 75390
Pathology (Hematology)
5323 HARRY HINES BLVD
DALLAS, TX 75390

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194740688, enumerated as an "individual" on July 13, 2006.

The provider is located at 5323 HARRY HINES BLVD DALLAS, TX 75390 and the phone number is (214) 730-5437.

Pediatrics with taxonomy code 2080P0207X and a focus in Pediatric Hematology-Oncology.

The provider might be accepting Accepts: Baylor Scott and White Health Plan and Blue Cross. Please consult your insurance carrier or call the provider to verify.