MS. ANGELA K WICKSTRUM PA-C
NPI 1912137977
Physician Assistant in Fort Worth, TX

Q: What is Angela Wickstrum's NPI number?

The NPI number for Angela Wickstrum is 1912137977. It was assigned to this individual provider in the NPPES registry on July 23, 2009.

Q: What is Angela Wickstrum's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Angela Wickstrum was last updated on September 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since July 23, 2009PECOS EnrolledAccepts Medicare Assignment

4115 E LANCASTER AVE, FORT WORTH, TX 76103(817) 369-8526(817) 764-0714 Get Directions Write a Review

NPPES record last updated: September 18, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 18, 2025, Jun 18, 2025 (2 updates tracked since 2025).

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About Ms. Angela K Wickstrum Pa-c NPPES

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

MS. ANGELA K WICKSTRUM PA-C (NPI 1912137977) is an individual physician assistant in Fort Worth, Texas, licensed in Texas (PA04934) and active in the NPI registry since July 2009. She is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1912137977

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMS. ANGELA K WICKSTRUMCredential: PA-C

Location Address4115 E LANCASTER AVEFort Worth, TX 76103-3614

Mailing AddressPo Box 746079Atlanta, GA 30374-6079 · (773) 352-1515 · Fax (312) 929-0373

Phone(817) 369-8526

Fax(817) 764-0714

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateJuly 23, 2009

Last NPPES UpdateSeptember 18, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 18, 2025

✔ NPI 1912137977 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 TX · PA04934

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.

4115 E LANCASTER AVE, Fort Worth, TX 76103

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.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

Ms. Angela K Wickstrum Pa-c 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 ID7214337773

PECOS Enrollment IDI20210621002223

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

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.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76103 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

$87.20 typical visit price

range $56.47 – $171.07

Typical copayment $21.80 (range $14.11 – $42.76)

Most-billed visit code 99203

Established Patient

$70.45 typical visit price

range $18.18 – $139.68

Typical copayment $17.61 (range $4.54 – $34.92)

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.

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Other Providers at the Same Location NPPES 15

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

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