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MR. LIAM ANDREW WICKENBURG
NPI 1750074563
Physician Assistant in Meridian, ID

Active since May 29, 2023PECOS EnrolledAccepts Medicare Assignment
520 S EAGLE RD STE 1241, MERIDIAN, ID 83642(208) 381-6930(208) 381-6931 Get Directions Write a Review

NPPES record last updated: October 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 4, 2025, May 29, 2023 (2 updates tracked since 2023).

About Mr. Liam Andrew Wickenburg NPPES

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

MR. LIAM ANDREW WICKENBURG (NPI 1750074563) is an individual physician assistant in Meridian, Idaho, licensed in Idaho (8871273) and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and maintains a secondary practice location in Kuna.

NPPES Registry Identity

NPI1750074563
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. LIAM ANDREW WICKENBURG
Location Address520 S EAGLE RD STE 1241Meridian, ID 83642-6355
Mailing Address190 E Bannock StBoise, ID 83712-6241
Phone(208) 381-6930
Fax(208) 381-6931
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateMay 29, 2023
Last NPPES UpdateOctober 15, 20252 updates tracked since enumeration
NPPES CertifiedOctober 15, 2025
✔ NPI 1750074563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in ID · 8871273
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
520 S EAGLE RD STE 1241, Meridian, ID 83642
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Secondary Practice Location 1

Location 1631 N Moonglow AveKuna, ID 83634-2198 · Phone (707) 666-1096

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

Mr. Liam Andrew Wickenburg 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 ID7618466822
PECOS Enrollment IDI20251028004965
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 2

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

St Luke's Regional Medical Center

Acute Care Hospitals · Boise, ID
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number130006
Location190 East Bannock StreetBoise, ID 83712 · Ada County
Emergency services Birthing friendly

St Luke's Nampa Medical Center

Acute Care Hospitals · Nampa, ID
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number130071
Location9850 West St Lukes DriveNampa, ID 83687 · Canyon County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83642 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
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
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 12

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

DR. ETHAN A FERREL MD
Surgery
520 S EAGLE RD STE 1241
MERIDIAN, ID 83642
Ada County (208) 381-6930
TRACEY REEVE PA-C
Physician Assistant (Surgical)
520 S EAGLE RD STE 1241
MERIDIAN, ID 83642
Ada County (208) 381-6930
CARLY PETRIE PA
Physician Assistant (Surgical)
520 S EAGLE RD STE 1241
MERIDIAN, ID 83642
Ada County (208) 381-6930
DR. BRITANI RHEA HILL MD
Surgery
520 S EAGLE RD STE 1241
MERIDIAN, ID 83642
Ada County (208) 381-6930
CLAYTON MILLER D.O.
Surgery
520 S EAGLE RD STE 1241
MERIDIAN, ID 83642
Ada County (208) 381-6930
ERIN GROSSLIGHT ACNP
Nurse Practitioner (Acute Care)
520 S EAGLE RD STE 1241
MERIDIAN, ID 83642
Ada County (208) 381-6930
DARYL A. REID M.D.
Surgery
520 S EAGLE RD STE 1241
MERIDIAN, ID 83642
Ada County (208) 381-6930
DR. CHRISTY LYN SMITH M.D.
Surgery
520 S EAGLE RD STE 1241
MERIDIAN, ID 83642
Ada County (208) 381-6930

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 Liam Wickenburg's NPI number?

The NPI number for Liam Wickenburg is 1750074563. It was assigned to this individual provider in the NPPES registry on May 29, 2023.

Where is Liam Wickenburg located?

Liam Wickenburg practices at 520 S Eagle Rd Ste 1241, Meridian, ID 83642. The listed phone number is (208) 381-6930.

What is Liam Wickenburg's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Liam Wickenburg enrolled in Medicare?

Yes. Liam Wickenburg 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.

Is Liam Wickenburg affiliated with any hospitals?

According to CMS data, Liam Wickenburg is affiliated with St Luke's Regional Medical Center and St Luke's Nampa Medical Center.

When was this NPI record last updated?

The NPPES record for Liam Wickenburg was last updated on October 15, 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.