WADE WYCKOFF
NPI 1689243149
Physical Medicine & Rehabilitation in Shreveport, LA

Active since June 20, 2021PECOS EnrolledAccepts Medicare Assignment
1111 LINE AVE, SHREVEPORT, LA 71101(318) 716-4545 Get Directions Write a Review

NPPES record last updated: October 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wade Wyckoff NPPES

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

WADE WYCKOFF (NPI 1689243149) is an individual physical medicine & rehabilitation provider in Shreveport, Louisiana, licensed in Louisiana (346157) and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS, is affiliated with Willis Knighton Medical Center, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1689243149
Entity TypeIndividualMale
Primary Taxonomy208100000X
Provider Legal NameWADE WYCKOFF
Location Address1111 LINE AVEShreveport, LA 71101-3841
Mailing Address1111 Line AveShreveport, LA 71101-3841 · (318) 716-4545
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateJune 20, 2021
Last NPPES UpdateOctober 14, 2025
NPPES CertifiedOctober 14, 2025
NPI 1689243149 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysical Medicine & RehabilitationAllopathic & Osteopathic Physicians
Taxonomy Code208100000X
License Licensed in LA · 346157
Definition
Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.
1111 LINE AVE, Shreveport, LA 71101

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

Wade Wyckoff 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 ID3678068921
PECOS Enrollment IDI20251223004140
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.

Hospital Affiliations CMS Care Compare

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

Willis Knighton Medical Center

Acute Care Hospitals · Shreveport, LA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190111
Location2600 Greenwood RoadShreveport, LA 71103 · Caddo County
Emergency services Birthing friendly

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.

Physical Therapist
1111 LINE AVE
SHREVEPORT, LA 71101
Nurse Practitioner (Psychiatric/Mental Health)
1111 LINE AVE
SHREVEPORT, LA 71101
Internal Medicine
1111 LINE AVE
SHREVEPORT, LA 71101
Physical Medicine & Rehabilitation
1111 LINE AVE
SHREVEPORT, LA 71101
Physical Medicine & Rehabilitation
1111 LINE AVE
SHREVEPORT, LA 71101
Internal Medicine
1111 LINE AVE
SHREVEPORT, LA 71101

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 Wade Wyckoff's NPI number?

The NPI number for Wade Wyckoff is 1689243149. It was assigned to this individual provider in the NPPES registry on June 20, 2021.

Where is Wade Wyckoff located?

Wade Wyckoff practices at 1111 Line Ave, Shreveport, LA 71101. The listed phone number is (318) 716-4545.

What is Wade Wyckoff's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation with taxonomy code 208100000X.

Is Wade Wyckoff enrolled in Medicare?

Yes. Wade Wyckoff 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.

What insurance does Wade Wyckoff accept?

Health plans from UnitedHealthcare list Wade Wyckoff as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Wade Wyckoff affiliated with any hospitals?

According to CMS data, Wade Wyckoff is affiliated with Willis Knighton Medical Center.

When was this NPI record last updated?

The NPPES record for Wade Wyckoff was last updated on October 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.