Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alexander Wicksman

Individual provider Physical Therapist · NPI 1114889235

Alexander Wicksman is a Physical Therapist in Private Practice in Camarillo, California. Qualified in 2025, 1 year ago. Practices with Mdrs Spine and Sport Inc, a 182-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2025
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Practice location Address checks out

450 Rosewood Ave Ste 105
Camarillo, CA 93010-5914
Phone: (805) 389-4781
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 309313 (CA)

Record details

NPI number1114889235
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 26, 2025
Last updated in NPPESNovember 26, 2025
Certification dateNovember 24, 2025
Mailing address22844 Dolorosa St, Woodland Hills, CA 91367-4319

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Mdrs Spine And Sport Inc — 182 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Camarillo