DR. KYLE RAYNOR WICOMB
NPI 1558865147
Internal Medicine in Elmhurst, NY
About Dr. Kyle Raynor Wicomb NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KYLE RAYNOR WICOMB (NPI 1558865147) is an individual internal medicine provider in Elmhurst, New York, licensed in California (A176702) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Kyle Raynor Wicomb 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.
Medicare Billing Reassignments
3Medicare enrollment records show Kyle Wicomb reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Colton, CA 92324
- Reassigned Medicare billing, Hawaii enrollment
- 56 clinicians in this Medicare group
Porterville, CA 93257
- Reassigned Medicare billing, California enrollment
- 159 clinicians in this Medicare group
Hilo, HI 96720
- Reassigned Medicare billing, Hawaii enrollment
- 43 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 5
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11373 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ELMHURST, NY 11373
ELMHURST, NY 11373
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 Kyle Wicomb's NPI number?
The NPI number for Kyle Wicomb is 1558865147. It was assigned to this individual provider in the NPPES registry on March 20, 2018.
Where is Kyle Wicomb located?
Kyle Wicomb practices at 7901 Broadway # A1-16, Elmhurst, NY 11373. The listed phone number is (718) 334-2488.
What is Kyle Wicomb's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Kyle Wicomb enrolled in Medicare?
Yes. Kyle Wicomb 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.
Which organizations bill Medicare for Kyle Wicomb's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kyle Wicomb reassigns Medicare benefits to 3 organizations: Quantum Healthcare Medical Associates Inc. (Colton, CA), 24 On Physicians Of California, PC (Porterville, CA) and Hawaii Post-Acute Medical Services 1 Inc (Hilo, HI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kyle Wicomb's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kyle Wicomb was last updated on January 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Dr. Kyle Raynor Wicomb · NPI 1558865147
Internal Medicine physician in Elmhurst, New York. Individual provider, active in the CMS NPPES registry since March 20, 2018.
## Identity
- **NPI:** 1558865147 (Entity type: Individual)
- **Enumerated:** March 20, 2018
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** A176702 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 7901 BROADWAY # A1-16, Elmhurst, NY 11373-1329
- **Phone:** (718) 334-2488
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Quantum Healthcare Medical Associates Inc. (NPI 1568490597, Colton, CA); 24 On Physicians Of California, PC (NPI 1730570565, Porterville, CA); Hawaii Post-Acute Medical Services 1 Inc (NPI 1780171074, Hilo, HI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** January 30, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1558865147) · Data from the CMS NPPES public registry.