Dr Wade Kc Licup, MD - Medicare Family Medicine in Vista, CA

  1. Home
  2. Family Medicine
  3. CA
  4. Vista
Dr Wade Kc Licup, MD is a medicare enrolled "Family Medicine" physician in Vista, California. His current practice location is 130 Cedar Rd, Vista, California. You can reach out to his office (for appointments etc.) via phone at (760) 806-5500.

Dr Wade Kc Licup is licensed to practice in California (license number A179911) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1881157998.

Contact Information

Dr Wade Kc Licup, MD
130 Cedar Rd,
Vista, CA 92083-5102
(760) 806-5500
Not Available

Map and Direction




Physician's Profile

Full NameDr Wade Kc Licup
GenderMale
SpecialityFamily Medicine
Location130 Cedar Rd, Vista, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1881157998
  • Provider Enumeration Date: 04/08/2019
  • Last Update Date: 04/28/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2163805292
  • Enrollment ID: I20220822003202

Medical Identifiers

Medical identifiers for Dr Wade Kc Licup such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1881157998NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine A179911 (California)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Wade Kc Licup allows following entities to bill medicare on his behalf.
Entity NameScripps Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275899072
PECOS PAC ID: 9234033853
Enrollment ID: O20031124000822
Entity NameThe Regents Of The University Of California
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1235107566
PECOS PAC ID: 1355248584
Enrollment ID: O20031223000439
Entity NameRegents Of The University Of California
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1891110888
PECOS PAC ID: 5294958815
Enrollment ID: O20140528001538

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Wade Kc Licup is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Wade Kc Licup, MD
10790 Rancho Bernardo Rd,
San Diego, CA 92127-5705

Ph: (760) 806-5500		Dr Wade Kc Licup, MD
130 Cedar Rd,
Vista, CA 92083-5102

Ph: (760) 806-5500

Reviews and Comments


Family Medicine Doctors in Vista, CA

Mary C. Cueva, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 326 S Melrose Dr Ste 200, Vista, CA 92081
Phone: 866-228-2236    Fax: 760-330-9331
James V. Chabala, M.D.
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 840 Townsite Dr, Vista, CA 92084
Phone: 760-630-2422    
Kristina Lepard, PA-C
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 204 S Santa Fe Ave, Vista, CA 92084
Phone: 760-941-8888    
Mrs. Deisha Malones Wilson, D.O.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 145 Thunder Dr, Vista, CA 92083
Phone: 760-941-9002    Fax: 760-630-2515
Ms. Juvy Escalante, PA
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 204 S Santa Fe Ave, Vista, CA 92084
Phone: 760-473-0444    
Alexander Shaft,
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 130 Cedar Rd, Vista, CA 92083
Phone: 760-806-5431    
Sophia Le Bradley, D.O.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 130 Cedar Rd, Vista, CA 92083
Phone: 760-806-5500    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.