Organization Active NPI

Waring Court Pediatric and Adult Medical Group

Doing business as Surfside Medical Group

  • Family Medicine Physician
  • Oceanside, CA
National Provider Identifier
1164483723
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A113589 Issued in CA
Legal business name
WARING COURT PEDIATRIC AND ADULT MEDICAL GROUP
Doing business as
Surfside Medical Group
Practice address
3230 Waring CT
Suite J
Oceanside, CA 92056-4509
Phone
(760) 941-4498
Fax
(760) 941-6938
NPI assigned
Mar 31, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Authorized official

Name
Evanne Wilkey
Title
Practice Director
Phone
(760) 941-4498

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A113589 CA Primary
Medical Physician Assistant 363AM0700X PA19297 CA
Family Nurse Practitioner 363LF0000X PA15228 CA

Addresses

Primary practice location

3230 Waring CT
Suite J
Oceanside, CA 92056-4509

Mailing address

3230 Waring CT Ste J
Oceanside, CA 92056-4509
Phone (760) 941-4498

Other practice location 1

3609 Ocean Ranch Blvd Ste 110
Oceanside, CA 92056-2698
Phone (760) 941-4498

Other identifiers 1

IdentifierTypeStateIssuer
1164483723OtherCANPI

Other names 1

  • Surfside Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041217000241 CA Part B Supplier - Clinic/Group Practice 5890752109 Receives reassigned benefits from 3 practitioners
Practice locations: Oceanside, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0568292Waring Court Pediatric & Adult Med GRP3230 Waring Court Suite J, Oceanside, CA 92056Certificate of waiverMar 7, 2027

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790640000000",
    "number": "1164483723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 WARING CT STE J",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564509",
            "telephone_number": "760-941-4498",
            "fax_number": "760-941-6938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 WARING CT",
            "address_2": "SUITE J",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564509",
            "telephone_number": "760-941-4498",
            "fax_number": "760-941-6938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3609 Ocean Ranch Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "920562698",
            "country_code": "US",
            "telephone_number": "760-941-4498",
            "fax_number": "760-941-6938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WARING COURT PEDIATRIC AND ADULT MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A",
        "authorized_official_last_name": "WILKEY",
        "authorized_official_first_name": "EVANNE",
        "authorized_official_title_or_position": "PRACTICE DIRECTOR",
        "authorized_official_telephone_number": "760-941-4498"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A113589",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA19297",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "PA15228",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1164483723",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surfside Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.