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Active NPI 1750995577 Individual Practitioner Male Practitioner

Kyle Rollin Wicks , PA-C

Physician Assistant • Roseburg, OR

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Kyle Wicks, PA-C is a certified Physician Assistant practicing in Roseburg, OR. With approximately 6 years of clinical experience since completing medical education in 2020, Kyle Wicks delivers high-quality medical care to the local community at 2570 NW EDENBOWER BLVD STE 100.

Kyle Wicks maintains professional affiliations with Evergreen Family Medicine Pc, Centennial Medical Group East Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include automated urinalysis test, detection test by immunoassay with direct visual observation for influenza virus, routine electrocardiogram (ecg) using at least 12 leads with tracing. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2570 Nw Edenbower Blvd Ste 100

Roseburg, OR 974716214

Telephone 5416777200
Fax 5412293309
Associated Practice Facility / Clinic
🏢 Evergreen Family Medicine, Pc Facility NPI 1417929050

Medicare Profile & Education

Medical School

Other

Graduation Year

2020

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Roseburg, OR

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
6 Yrs -2.8 yrs vs City Avg
City Avg: 8.8 Yrs
State Avg: 10.5 Yrs
Regional Practice Density
34 Specialists

Practicing in Roseburg, OR (2106 Statewide)

Telehealth Adoption Rate
2.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
68.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wicks (6 Years) 6 Yrs
Roseburg Specialty Average (8.8 Years) 8.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
81003 Automated urinalysis test
120 114 $25.00 $2.20
87804 Detection test by immunoassay with direct visual observation for influenza virus
44 23 $40.00 $16.22
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing
28 27 $23.52 $6.02
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)
13 13 $40.00 $16.20

Medical Specialties & State Licenses

CMS Verified: 2023-02-06
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
500804257 (OR)

Hospital & Practice Group Affiliations

Evergreen Family Medicine Pc

2570 Nw Edenbower Blvd, Roseburg, OR 974716214

Phone: 5416777200

Evergreen Family Medicine Pc

2570 Nw Edenbower Blvd, Roseburg, OR 974716214

Phone: 5416777200

Evergreen Family Medicine Pc

2570 Nw Edenbower Blvd, Roseburg, OR 974716214

Centennial Medical Group East Llc

249 Dakota St, Sutherlin, OR 974799908

Phone: 5416777200

Centennial Medical Group East Llc

2570 Nw Edenbower Blvd, Roseburg, OR 974716214

Phone: 5416777200

Centennial Medical Group East Llc

2570 Nw Edenbower Blvd, Roseburg, OR 974716214

Phone: 5416777200

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Charlene Davis , PMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1023728573

Psychiatric-Mental Health Nurse Practitioner

Dr. Brandon Bonds , MD

Family Medicine

NPI 1033406053

Doctor of Medicine (M.D.)

Gerilynn Jutson , RN

Registered Nurse

NPI 1033955711

Registered Nurse

Kathleen Riordan , FNP

Nurse Practitioner - Family

NPI 1033984554

Family Nurse Practitioner

Paul Fieber , PA

Physician Assistant

NPI 1043371305

Physician Assistant

April Green

Counselor - Mental Health

NPI 1053022830

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location April 14, 2022

Registered at 2570 NW EDENBOWER BLVD STE 100, ROSEBURG, OR 974716214 (Tel: 5416777200)

📍
Updated Business Mailing Address April 14, 2022

Registered at 2570 NW EDENBOWER BLVD STE 100, ROSEBURG, OR 974716214 (Tel: 5416777200)

NPI Profile Active August 31, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location August 31, 2020

Registered at 1706 WASHINGTON WAY, LONGVIEW, WA 986322952 (Tel: 3604239580)

📍
Updated Business Mailing Address August 31, 2020

Registered at 4054 CANAL WOODS CT, LAKE OSWEGO, OR 970347221 (Tel: 5034804676)

👤
Provider Name / Credentials Updated August 31, 2020

Recorded as KYLE WICKS, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 31, 2020

Physician Assistant

🟢
Initial NPI Registration & Enumeration August 31, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1750995577
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 31, 2020
Last Update: February 06, 2023
Sole Proprietor: No

Mailing Address

2570 Nw Edenbower Blvd Ste 100

Roseburg, OR 974716214

Phone: 5416777200

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.