Individual provider Active NPI

Paul Nicholas Wilson, M.D.

  • Anesthesiology Physician
  • Murrieta, CA
National Provider Identifier
1104028380
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A 112847 Issued in CA
Practice address
25500 Medical Center Dr
Southwest Healthcare System - Medical Staff Services
Murrieta, CA 92562-5965
Phone
(951) 696-6124
Fax
(951) 696-6293
NPI assigned
Jun 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X A 112847 CA Primary

Addresses

Primary practice location

25500 Medical Center Dr
Southwest Healthcare System - Medical Staff Services
Murrieta, CA 92562-5965

Mailing address

25500 Medical Center Dr
Southwest Healthcare System - Medical Staff Services
Murrieta, CA 92562-5965
Phone (951) 696-6124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101027001503 CA Practitioner - Anesthesiology 7315131935 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians Anesthesiology of California PCGroup PAC ID 4385027770, 35 clinicians

Practice addresses (Care Compare)

28062 Baxter Rd
Murrieta, CA 92563-1401
Phone (951) 290-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
112847CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Anesthesiology of California PC Anesthesiology CurrentSince Jan 16, 2023 Accepting new patients
Resilience Integrative CurrentSince Sep 12, 2023 Accepting new patients
Innovative Anesthesia Consultants PC Anesthesiology CurrentSince Nov 4, 2023 Accepting new patients
Orion Anesthesia Consultants Inc Anesthesiology CurrentSince Apr 14, 2012 Accepting new patients

Locations

28062 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

8945 Magnolia Ave
Ste 200
Riverside, CA 92503
Phone (951) 643-4961

6719 Alvarado Rd
Ste 201
San Diego, CA 92120
Phone (619) 265-4020

Interoperability endpoints

  • Direct secure messaging: pwilson182191@direct.llu.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1104028380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 MEDICAL CENTER DR",
            "address_2": "SOUTHWEST HEALTHCARE SYSTEM - MEDICAL STAFF SERVICES",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625965",
            "telephone_number": "951-696-6124",
            "fax_number": "951-696-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 MEDICAL CENTER DR",
            "address_2": "SOUTHWEST HEALTHCARE SYSTEM - MEDICAL STAFF SERVICES",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625965",
            "telephone_number": "951-696-6124",
            "fax_number": "951-696-6293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PAUL",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A 112847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.