KASSIE IDICULA (PA) – Physician Assistant, NPI 1952711947

Physician Assistant

KASSIE IDICULA (PA) is a healthcare provider. based in Lubbock, Texas. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. PA08972 (TX). The NPI Number for KASSIE IDICULA (PA) is 1952711947

Main info

Female

13 Years Of Experience

Accepts Medicare Assignment

Name

KASSIE IDICULA (PA)

NPI

1952711947

Phone

(806) 744-7223

Address

2804 N LOOP 289

Enumeration Date

30 April 2014

Last Update Date

13 October 2014

Doctor Profile

Medical School Name

OTHER

Secondary Phone

8067974985

Graduation Year

2013 (13 years ago)

PAC ID

0345562039

Group Practice PAC ID

3173579844

Professional Enrollment ID

I20141209000121

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience38

Completeness75

Years active:12State licenses:1Digital endpointsOther names

Provider Addresses for KASSIE IDICULA (PA)

2804 N LOOP 289
LUBBOCK, TX 794151410
Phone: (806) 744-7223
Fax: (806) 740-3325
Type: Mailing
2412 50TH ST
LUBBOCK, TX 794122504
Phone: (806) 744-7223
Fax: (806) 740-3325
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.

No Medicare enrollment or revalidation data available for this provider in our database.

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 79415)

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Provider's Procedures

KASSIE IDICULA (PA) performs procedures in Physician Assistant. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
PHYSICIAN ASSISTANT	TX	20610	Aspiration and/or injection of large joint or joint capsule	32	27
PHYSICIAN ASSISTANT	TX	73562	X-ray of knee, 3 views	34	32

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: 3173579844View full group profile

Name	Specialty	State
BERTRAND BODO (NP)	Nurse Practitioner	TX
DR. KENNETH A STEPHENSON (MD)	Orthopedic Surgery	TX
DR. JOSEPH NATHAN WILSON (M.D.)	-	TX
DR. DYLAN THOMAS HOMEN (MD)	Orthopedic Surgery	TX
MICHEAL REDDELL (PA)	Physician Assistant	TX
JANA LEIGH REDWINE (PA-C)	Physician Assistant	TX
HAYDEN ROBERT GOMEZ (PA-S2)	Physician Assistant	TX
SHAUNA FERGUSON (PT, SCD)	Physical Therapist In Private Practice	TX
Unknown Individual	-	TX