DALE ALAN WICKSTRUM MD
NPI 1306890322
Radiology - Radiation Oncology in Tallahassee, FL

Q: What is Dale Wickstrum's NPI number?

The NPI number for Dale Wickstrum is 1306890322. It was assigned to this individual provider in the NPPES registry on May 22, 2006.

Q: What is Dale Wickstrum's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Radiation Oncology, with taxonomy code 2085R0001X.

Q: When was this NPI record last updated?

The NPPES record for Dale Wickstrum was last updated on November 23, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 May 22, 2006PECOS EnrolledAccepts Medicare Assignment

2003 CENTRE POINTE BLVD, TALLAHASSEE, FL 32308(850) 878-2273(850) 671-5900 Get Directions Write a Review

NPPES record last updated: November 23, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dale Alan Wickstrum Md NPPES

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

DALE ALAN WICKSTRUM MD (NPI 1306890322) is an individual radiation oncology provider in Tallahassee, Florida, licensed in Florida (ME0035684) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Sovah Health Danville, and is a graduate of University Of Florida College Of Medicine (1976).

NPPES Registry Identity

NPI1306890322

Entity TypeIndividualMale

Primary Taxonomy2085R0001X

Provider Legal NameDALE ALAN WICKSTRUMCredential: MD

Location Address2003 CENTRE POINTE BLVDTallahassee, FL 32308-4893

Mailing AddressPo Box 14446Tallahassee, FL 32317-4446 · (850) 222-4858 · Fax (850) 431-6591

Phone(850) 878-2273

Fax(850) 671-5900

Sole ProprietorNo

Medical School CMSUniversity Of Florida College Of MedicineGraduated 1976

Enumeration DateMay 22, 2006

Last NPPES UpdateNovember 23, 2015

✔ NPI 1306890322 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Radiation OncologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0001X

License✔ Licensed in FL · ME0035684

Definition

A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.

2003 CENTRE POINTE BLVD, Tallahassee, FL 32308

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Other Identifiers 3

Medicare UPIND57106

Medicaid051677500FL

Medicare ID-Type Unspecified61109ZFL

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

Dale Alan Wickstrum 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 ID3577524578

PECOS Enrollment IDI20200122001037

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 2

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.

Ct guidance for insertion of radiation therapy fields 77014

CT guidance for insertion of radiation therapy fields involves using a CT scan to accurately map the area of your body where radiation will be applied. This ensures the radiation targets only the necessary area, minimizing impact to healthy tissues.

92 services26 patients

Radiation treatment management, 5 treatment sessions 77427

Radiation treatment management involves a series of 5 sessions where targeted radiation is used to destroy or shrink cancer cells in your body. Each session is carefully planned to maximize effectiveness while minimizing harm to healthy tissues. You may experience side effects which will be closely monitored and managed for your comfort.

19 services17 patients

Hospital Affiliations CMS Care Compare

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

Sovah Health Danville

Acute Care Hospitals · Danville, VA

2/5 CMS rating

OwnershipProprietary

CMS Certification Number490075

Location142 South Main StreetDanville, VA 24541 · Danville City County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32308 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

$171.84 typical visit price

range $56.00 – $171.84

Typical copayment $42.96 (range $14.00 – $42.96)

Most-billed visit code 99205

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

Most-billed visit code 99213

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 5

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

DR. JOSHUA BRIAN DAULT MD

Radiology (Radiation Oncology)