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DR. GARY JOHN VICIK M.D. NPI 1295708212


NPI Information

NPI: 1295708212
Provider Name: DR. GARY JOHN VICIK, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual
Organization: DERMASSOCIATES LTD

PECOS Registration: Yes

Address:
3608 W MAIN ST
BELLEVILLE, IL
ZIP 62226
Phone: (618) 397-6605
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DR. Gary John Vicik, M.D. is a specialist in Belleville, IL with 55 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Gary John Vicik, M.D. NPI is 1295708212. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1969

The provider's business location address is:

3608 W MAIN ST
BELLEVILLE, IL
ZIP 62226-225
Phone: (618) 397-6605
Fax: (618) 277-1251

The NPI 1295708212 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Destruction of 2-14 skin growths (HCPCS:17003)
  • Pathology examination of tissue using a microscope, intermediate complexity (HCPCS:88305)
  • Destruction of skin growth (HCPCS:17000)
  • Biopsy of single growth of skin and/or tissue (HCPCS:11100)
  • Destruction of up to 14 skin growths (HCPCS:17110)
  • Biopsy of each additional growth of skin and/or tissue (HCPCS:11101)
  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
  • Pathology examination of tissue using a microscope, moderately low complexity (HCPCS:88304)

The enumeration date for this NPI number is 2/9/2006 and was last updated on 5/21/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist36-49185ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
111512OTHERESSENCE
242561V34432OTHERADVANTRA
3101263OTHERHEALTHLINK
4202982OTHERGREAT WEST
5C35063MEDICARE UPINILLINOIS
68215117OTHERILLINOISBLUE SHIELD
7231410MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
842561V34432OTHERGROUP HEALTH PLAN
9791071011MEDICARE ID-TYPE UNSPECIFIEDRAILROAD MEDICARE
10036049185MEDICAIDILLINOIS
110778106OTHERAETNA
12STL0307017OTHERUNITED HEALTHCARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.