DR. JACE JAMES RICKSTREW (MD) – Dermatology Physician, NPI 1992209472

DR. JACE JAMES RICKSTREW (MD) is a healthcare provider. based in Wichita, Kansas. specializing in DERMATOLOGY, MICROGRAPHIC DERMATOLOGIC SURGERY (MDS). They hold the professional credentials MD. They hold a License No. 04-48669 (KS). The NPI Number for DR. JACE JAMES RICKSTREW (MD) is 1992209472

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
DR. JACE JAMES RICKSTREW (MD)
NPI
1992209472
Phone
(316) 612-1833
Address
9300 E 29TH ST N STE 310
Enumeration Date
20 March 2018
Last Update Date
26 September 2025

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
7858272500
Graduation Year
2018 (8 years ago)
PAC ID
8729338991
Group Practice PAC ID
1951388289
Professional Enrollment ID
I20231212000847
Address ID
KS665037603MA4201XAVEX308
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness85
Years active:8State licenses:1Digital endpointsOther names

91 DERMATOLOGY in NV

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Provider Addresses for DR. JACE JAMES RICKSTREW (MD)

  • 9300 E 29TH ST N STE 310

    WICHITA, KS 672262160

    Phone: (316) 612-1833

    Fax: (316) 612-2420

    Type: Mailing

  • MountainView Hospital, 3100, North Tenaya Way, Las Vegas, Clark County, Nevada, 89128, United States

    GRADUATE MEDICAL EDUCATION

    LAS VEGAS, NV 891280431

    Phone:

    Type: Mailing

  • 828 Elmhurst Blvd

    Salina, KS 674017406

    Phone: (785) 827-2500

    Fax: (785) 827-2515

    Type: Location

  • 4201 ANDERSON AVE STE F

    MANHATTAN, KS 665037603

    Phone: (785) 539-4645

    Fax: (785) 539-1655

    Type: Location

  • 6601 VAUGHT RANCH RD STE 200

    AUSTIN, TX 787302309

    Phone: (512) 628-0465

    Fax: (512) 233-2711

    Type: Mailing

  • 2504 RIDGE RD STE 102

    ROCKWALL, TX 750872570

    Phone: (214) 771-3100

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 37 Open Payments records for all available years, with a total value of $1,563.

Total Amount is formed as General ($1,563) + Research ($0) + Ownership ($0) = $1,563.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Janssen Biotech, Inc. ($377).

Total Amount

$1,563

General + Research + Ownership

Payments

37

Total payment records

General Amount

$1,563

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-12-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220627002194IDermatologyTXTBD
I20231212000847IDermatologyKSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths9621$0
99213Established patient office or other outpatient visit, 20-29 minutes3030$0
17000Destruction of precancer skin growth, 1 growth2926$0
11102Biopsy of related skin growth, first growth1716$0
View full utilization report →

Insurance plans in this area (ZIP 67226)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951388289View full group profile
NameSpecialtyState
Nurse PractitionerKS
D E R M A T O L O G YUT
Physician AssistantKS
Physician AssistantKS
Physician AssistantKS
Physician AssistantKS
Micrographic Dermatologic Surgery (Mds), DermatologyKS
Nurse PractitionerKS
Nurse PractitionerKS
Nurse PractitionerKS

Reviews

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Frequently asked questions

What unique ID ties claims to DR. JACE JAMES RICKSTREW (MD)?
NPI 1992209472 is assigned to DR. JACE JAMES RICKSTREW (MD) under the national enumeration system.
Is DR. JACE JAMES RICKSTREW (MD)'s NPI currently valid?
The extract we use shows DR. JACE JAMES RICKSTREW (MD) as active.
Does DR. JACE JAMES RICKSTREW (MD) list a primary specialty?
If you are matching referrals, note Dermatology Physician for DR. JACE JAMES RICKSTREW (MD). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. JACE JAMES RICKSTREW (MD)?
The page summarizes Wichita, Kansas for DR. JACE JAMES RICKSTREW (MD); expand the address list for detail.
Is DR. JACE JAMES RICKSTREW (MD) a real provider?
This page reflects official NPPES data for NPI 1992209472. Always confirm identity and privileges with the practice and licensing boards.

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