Vernon Raphael Wilson, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G62587 Issued in CA

Practice address

3445 Pacific Coast Hwy
Suite 220
Torrance, CA 90505-6658

Phone

(310) 937-9200

Fax

(310) 937-9522

NPI assigned

Apr 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Dermatology

Education

University of Missouri, Kansas City, School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Vernon R. Wilson, MD a Professional Medical Corporation

  • Dermatology Physician
  • Torrance, CA
  • NPI 1740663160
  Medicare reassignment NPD

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1114983467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 PACIFIC COAST HWY",
            "address_2": "SUITE 220",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056658",
            "telephone_number": "310-937-9200",
            "fax_number": "310-937-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 PACIFIC COAST HWY",
            "address_2": "SUITE 220",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056658",
            "telephone_number": "310-937-9200",
            "fax_number": "310-937-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "VERNON",
        "middle_name": "RAPHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G62587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janai Wilson
• Matthew Neil Cahill Wilson
• Nephiteria Wilson
• Rachael Ann Wilson, NURSE PRACTITIONER
• Tiffany Monique Wilson
• Afton Michelle Winchester
• Rhonda Windham
• Talena Wingfield
• Stuart Neil Winkler, M.D.
• Winnel Inc.

• Dermatology Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.