Kelly Wickstrom, D.O.

NPI 1083092589ActiveIndividual· Internal Medicine, Critical Care Medicine· Tucson, AZ

Internal Medicine, Critical Care Medicine (D.O.) in Tucson, Arizona, trained at Des Moines University of Osteopathic Medicine and Health Sciences (class of 2015). Mostly services rather than prescriptions: Medicare paid $4,916 for 20 patients in 2024, with only 20 Part D claims. Abiomed reported $36.74 in payments in 2025, mostly food and beverage.

Overview

NPI	1083092589
Status	Active
Entity type	Individual
Credential	D.O.
Sole proprietor	No
NPI issued	May 15, 2015
Last updated in NPPES	Apr 29, 2023
Certified by provider	Feb 10, 2023

Specialties and licenses

Taxonomy	Code	License	State
Internal Medicine, Critical Care Medicine Primary	207RC0200X	008816	AZ
Internal Medicine	207R00000X	008816	AZ
Internal Medicine	207R00000X	R2504	AZ
Internal Medicine, Pulmonary Disease	207RP1001X	008816	AZ

About license numbers in NPPES

Exclusion screening

List	Result	Details
HHS-OIG LEIE · Nov 10, 2026	No match	Checked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026	No match	—
New York OMIG · Nov 11, 2026	No match	—
Ohio Medicaid · Nov 11, 2026	No match	—
Pennsylvania Medicheck · Nov 11, 2026	No match	—
Washington HCA · Nov 11, 2026	No match	—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)	Enrolled Practitioner - Pulmonary Disease (AZ)
Accepts assignment	Yes (participating)

Medicare services in 2024

Medicare patients	20
Services billed	33 across 11 procedure codes
Paid by Medicare	$4,916

Part D prescriptions in 2024

Prescriptions (claims)	20 · 20 30-day fills
Total drug cost	$2,093

Medicare sources and data years

Education and affiliations

Medical school	Des Moines University of Osteopathic Medicine and Health Sciences
Graduation year	2015
Medicare specialty	Pulmonary Disease
Secondary specialties	Internal Medicine