DR. OTTO WILLIAM WICKSTROM III M.D.
NPI 1487826939
Orthopaedic Surgery - Hand Surgery in Bloomington, IN

Q: What is Otto Wickstrom's NPI number?

The NPI number for Otto Wickstrom is 1487826939. It was assigned to this individual provider in the NPPES registry on March 25, 2008.

Q: What is Otto Wickstrom's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Hand Surgery, with taxonomy code 207XS0106X.

Q: When was this NPI record last updated?

The NPPES record for Otto Wickstrom was last updated on April 29, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 25, 2008PECOS EnrolledAccepts Medicare Assignment

583 S CLARIZZ BLVD, BLOOMINGTON, IN 47401(812) 333-2663(812) 349-9206 Get Directions Write a Review

NPPES record last updated: April 29, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 29, 2021, Sep 15, 2020 (2 updates tracked since 2020).

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About Dr. Otto William Wickstrom Iii M.d. NPPES

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

DR. OTTO WILLIAM WICKSTROM III M.D. (NPI 1487826939) is an individual hand surgery provider in Bloomington, Indiana, licensed in Washington (MD61074238) and active in the NPI registry since March 2008. He is enrolled in Medicare PECOS, is affiliated with Indiana University Health Bloomington Hospital, and maintains a secondary practice location in Spokane Valley.

NPPES Registry Identity

NPI1487826939

Entity TypeIndividualMale

Primary Taxonomy207XS0106X

Provider Legal NameDR. OTTO WILLIAM WICKSTROM IIICredential: M.D.

Location Address583 S CLARIZZ BLVDBloomington, IN 47401-5515

Mailing Address583 S Clarizz BlvdBloomington, IN 47401-5515

Phone(812) 333-2663

Fax(812) 349-9206

Sole ProprietorNo

Medical School CMSOtherGraduated 2003

Enumeration DateMarch 25, 2008

Last NPPES UpdateApril 29, 20212 updates tracked since enumeration

NPPES CertifiedApril 29, 2021

✔ NPI 1487826939 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOrthopaedic Surgery · Hand SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207XS0106X

License✔ Licensed in WA · MD61074238

Definition

An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.

Also ListedSpecialistTaxonomy 174400000X · License 01065381A (IN)

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License MD61074238 (WA)

583 S CLARIZZ BLVD, Bloomington, IN 47401

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Secondary Practice Location 1

Location 116528 E Desmet CtSpokane Valley, WA 99216-3522 · Phone (509) 944-8920 · Fax (509) 227-7070

Other Identifiers 1

Medicaid200931500IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter 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

Dr. Otto William Wickstrom Iii 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 ID648322073

PECOS Enrollment IDI20090716000303

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 6

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.

57 services54 patients

Incision of tendon covering of finger 26055

This procedure involves making a small cut into the protective sheath around a finger tendon. It's typically done to relieve pressure or inflammation, improve finger movement, or treat conditions like trigger finger. It's a safe, often outpatient procedure.

32 services22 patients

Release and/or relocation of hand nerve 64721

This procedure involves adjusting or moving a nerve in your hand to alleviate discomfort or improve function. The nerve may be compressed, causing pain or numbness. By releasing or relocating the nerve, these symptoms can be reduced, enhancing hand usage.

25 services22 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

17 services12 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

16 services14 patients

X-ray of hand, minimum of 3 views 73130

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

15 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Indiana University Health Bloomington Hospital

Acute Care Hospitals · Bloomington, IN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150051

Location2651 East Discovery ParkwayBloomington, IN 47408 · Monroe County

Emergency services Birthing friendly

Indiana University Health

Acute Care Hospitals · Indianapolis, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150056

Location1701 N Senate BlvdIndianapolis, IN 46202 · Marion County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47401 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

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.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment L3906

DME-Orthotic Devices · category DF000N

1 supplier18 claims18 services$384.29 avg. paid by Medicare

Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf L3908

DME-Orthotic Devices · category DF000N

1 supplier24 claims24 services$51.02 avg. paid by Medicare

Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment L3913

DME-Orthotic Devices · category DF000N

1 supplier16 claims16 services$204.77 avg. paid by Medicare

Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment L3933

DME-Orthotic Devices · category DF000N

1 supplier15 claims15 services$134.97 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 20

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

KEVIN JOSEPH KATHMAN ORT

Occupational Therapist