DANE K WICKS (MD) – Family Medicine Physician, NPI 1912989138
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,330 FAMILY PRACTICE in MO
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Provider Addresses for DANE K WICKS (MD)
307 SW MARION LN
LEES SUMMIT, MO 640812315
Phone: (505) 977-5695
Fax: (816) 600-2169
Type: Mailing
4251, Northern Avenue, Kansas City, Jackson County, Missouri, 64133, United States
HONOR ANNEX KANSAS CITY VA
KANSAS CITY, MO 64133
Phone: (816) 922-2870
Fax: (816) 922-4823
Type: Location
5750 JOHNSTON ST STE 205
LAFAYETTE, LA 705035345
Phone: (337) 991-9276
Type: Mailing
400 SW LONGVIEW BLVD STE 280
LEES SUMMIT, MO 640812157
Phone: (337) 991-9276
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2004-08-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040809000835 | I | Family Practice | MO | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 64081)
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Group practice members
- 1
- 2
- 3
- 4
| Name | Specialty | State |
|---|---|---|
| Infectious Disease, Internal Medicine, Infectious Disease | MO | |
| Family Practice, Internal Medicine | MO | |
| General Practice, Emergency Medicine | MO | |
| Nurse Practitioner | MO | |
| Internal Medicine | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Internal Medicine | MO | |
| Family Practice | MO |
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