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

Andrea Leigh Wickus, PAC

Individual provider Physician Assistant · NPI 1104881879

Andrea Leigh Wickus, PAC is a Physician Assistant in Leesport, Pennsylvania. Qualified in 2004, 22 years ago. Practices with Penn State Health Medical Group LLC, a 711-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
22
Licensed in
PA
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

See every abbreviation used in this directory →

Practice location Address checks out

5 S Centre Ave
Leesport, PA 19533
Phone: (610) 926-5707
Fax: (610) 926-8352
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence OA005642 (PA)

Record details

NPI number1104881879
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorYes
NPI enumeratedApril 18, 2006
Last updated in NPPESJanuary 20, 2023
Certification dateJanuary 20, 2023
Mailing address5 S Centre Ave, Leesport, PA 19533-8653

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Penn State Health Medical Group Llc — 711 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare