Michael Wilkes, M.D.

Primary specialty

Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X

License

G064098 Issued in CA

Practice address

1 Shields Ave
Davis, CA 95616-5270

Phone

(530) 752-0321

NPI assigned

Apr 2, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwilkes200025@direct.ochin.org

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.

• Wellspace Health

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1124112933
  Medicare reassignment NPD
• Wellspace Health

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1104210608
  NPD
• Wellspace Health

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1114682689
  NPD
• Wellspace Health

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1124257324
  NPD (past)

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

{
    "created_epoch": "1270166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1194040063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SHIELDS AVE",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956165270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHIELDS AVE",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956165270",
            "telephone_number": "530-752-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKES",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "CA",
            "license": "G064098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "G064098",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige White
• Brooke Elizabeth Wickman, MS, RD
• Valerie Wiebe Howard, PHARMD
• Gregory D Wilcox, DDS
• Jeff Thomas Wilkes, M.D.
• Krystel Lejoia Wilkins, CNM
• Tia D. Will, MD
• Kevon Williams
• Marnie Kathleen Noelle Williams, BCBA
• Paul Williams, DPT

• Adolescent Medicine (Internal Medicine) Physician in Davis, CA
• Providers in Davis, CA by specialty
• Adolescent Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.