Bonita Rae Wickstrom, LISW
NPI 1225075161ActiveIndividual· Social Worker· Albuquerque, NM
Opted out of Medicare from July 2016 to July 2028. Social Worker (LISW) in Albuquerque, New Mexico, licensed in NM, with an NPI issued in May 2006.
Overview
| NPI | 1225075161 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LISW |
| Sole proprietor | No |
| NPI issued | May 31, 2006 |
| Last updated in NPPES | Jul 13, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker Primary | 104100000X | I-4390 | NM |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Opt-out | Opted out Jul 1, 2016 – Jul 1, 2028 |
| Can order and refer | Yes |
During an opt-out period the provider sees Medicare patients only under private contracts, and Medicare does not pay claims for their services.
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