Tyler Daniel Wickas, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in St Petersburg, Florida. His current practice location is
1515 9th Ave N, St Petersburg, Florida. You can reach out to his office (for appointments etc.) via phone at
(727) 895-2020.
Tyler Daniel Wickas is licensed to practice in New York (license number ) 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 1063041473.
Physician's Profile
Full Name | Tyler Daniel Wickas |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 1515 9th Ave N, St Petersburg, Florida |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1063041473
- Provider Enumeration Date: 04/07/2020
- Last Update Date: 08/05/2024
Medicare PECOS Information:
- PECOS PAC ID: 8527501147
- Enrollment ID: I20240624000992
Medical Identifiers
Medical identifiers for Tyler Daniel Wickas such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1063041473 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207W00000X | Ophthalmology | ME162826 (Florida) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (New York) | 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. Tyler Daniel Wickas allows following entities to bill medicare on his behalf.
Entity Name | Suncoast Eye Center Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1487643631 PECOS PAC ID: 4789777087 Enrollment ID: O20070831000439 |
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Entity Name | Pinellas Eye Care Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1306165493 PECOS PAC ID: 3577743996 Enrollment ID: O20110202000264 |
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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. Tyler Daniel Wickas 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 Address | Practice Location Address |
Tyler Daniel Wickas, MD 2201 Hempstead Tpke, East Meadow, NY 11554-1859 Ph: (516) 572-0123 | Tyler Daniel Wickas, MD 1515 9th Ave N, St Petersburg, FL 33705-1224 Ph: (727) 895-2020 |
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