Individual provider Active NPI

Kevin Wright, M.D.

  • Dermatology Physician
  • San Diego, CA
National Provider Identifier
1164700738
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD192149 Issued in OR
Practice address
6605 Nancy Ridge Dr
San Diego, CA 92121-2253
Phone
(858) 900-2766
Fax
(858) 900-2984
NPI assigned
Jul 29, 2011
Last updated
Oct 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD192149 OR Primary
MOHS-Micrographic Surgery Physician 207ND0101X MD192149 OR

Addresses

Primary practice location

6605 Nancy Ridge Dr
San Diego, CA 92121-2253

Mailing address

6605 Nancy Ridge Dr
San Diego, CA 92121-2253
Phone (858) 900-2766

Other identifiers 1

IdentifierTypeStateIssuer
500768882MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, CA, PA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20191001001945 OR Practitioner - Dermatology 3678803814 Reassigns benefits to 3 organizations
I20200430002804 CA Practitioner - Dermatology 3678803814 Reassigns benefits to 1 organization
I20221011002865 PA Practitioner - Dermatology 3678803814

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Uniformed Services Uhs Fe Hebert School of Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinic for Dermatology and Wellness LLCGroup PAC ID 5890083729, 6 clinicians

Practice addresses (Care Compare)

2924 Siskiyou Blvd
Suite 200
Medford, OR 97504-6462
Phone (541) 200-2777

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision149
Removal of skin lesions256
Removal of skin cancer769
Removal or shaving of skin growth1-10
Skin biopsy71

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic for Dermatology & Wellness LLC CurrentSince Sep 1, 2019 Accepting new patients
Wright Dermatology and Mohs, LLC Dermatology Past Accepting new patients

Locations

2924 Siskiyou Blvd
Ste 200
Medford, OR 97504
Phone (541) 200-2777

2937 Siskiyou Blvd
Ste 1
Medford, OR 97504
Phone (541) 200-2777

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1164700738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6605 NANCY RIDGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212253",
            "telephone_number": "858-900-2766",
            "fax_number": "858-900-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6605 NANCY RIDGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212253",
            "telephone_number": "858-900-2766",
            "fax_number": "858-900-2984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-29",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OR",
            "license": "MD192149",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "OR",
            "license": "MD192149",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500768882",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.