Larysa Wickman, M.D
NPI 1063603082 · Pediatric Nephrology Physician · Ann Arbor, MI
Enrolled with Medicare as Practitioner - Nephrology · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Larysa Wickman, M.D is a Pediatric Nephrology Physician provider in Ann Arbor, MI (NPI 1063603082).
Provider details
- NPI number
- 1063603082
- Entity type
- Individual
- Primary specialty
- Pediatric Nephrology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D
- Sex
- Female
- Sole proprietor
- No
- License
- 4301089772 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 3535 W 13 Mile Rd Ste 707Royal Oak, MI 48073-6770Phone: (248) 551-0487Fax: (248) 551-3696
Registry dates
- Enumerated
- 2007-08-06
- Last updated
- 2020-10-20
- Certified
- 2020-10-20
Frequently asked questions
- What is Larysa Wickman's NPI number?
- Larysa Wickman's National Provider Identifier (NPI) is 1063603082, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Larysa Wickman's specialty?
- Larysa Wickman is listed in the NPPES registry with a primary specialty of Pediatric Nephrology Physician (Allopathic & Osteopathic Physicians).
- Where is Larysa Wickman located?
- Larysa Wickman's practice location on file with NPPES is 1500 E Medical Center Dr, Ann Arbor, MI 48109-5318.
- What is Larysa Wickman's phone number?
- The practice phone number listed in the NPPES registry for Larysa Wickman is (734) 936-4210.
- Does Larysa Wickman accept Medicare?
- Larysa Wickman is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Larysa Wickman's NPI active?
- Yes — Larysa Wickman's NPI (1063603082) is active in the NPPES registry as of the last update on 2020-10-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.