Individual provider Active NPI

Martha Carmella Wilkins, PA-C

  • Medical Physician Assistant
  • Walnut Creek, CA
National Provider Identifier
1215508775
Registry record updated Sep 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
2123 Ygnacio Valley Rd Ste 200
Walnut Creek, CA 94598-3395
Phone
(925) 926-0195
NPI assigned
Jul 6, 2021
Last updated
Sep 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X CA Primary

Addresses

Primary practice location

2123 Ygnacio Valley Rd Ste 200
Walnut Creek, CA 94598-3395

Mailing address

2123 Ygnacio Valley Rd Ste K200
Walnut Creek, CA 94598-3336

Other practice location 1

2222 East St Ste 310
Concord, CA 94520-2055
Phone (925) 685-4533

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL n/a Health Information Exchange (HIE)

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220620001883 CA Practitioner - Physician Assistant 1254710320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2123 Ygnacio Valley Rd
Suite K200
Walnut Creek, CA 94598-3336
Phone (925) 926-0195

2800 N California St
Suite 15a
Stockton, CA 95204-3759
Phone (925) 926-0195

6600 Lone Tree Way
Suite B
Brentwood, CA 94513-5256
Phone 92592601955256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
59706CAMDClinical Social Worker

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664064000000",
    "number": "1215508775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 YGNACIO VALLEY RD STE K200",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 YGNACIO VALLEY RD STE 200",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983395",
            "telephone_number": "925-926-0195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 East St Ste 310",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945202055",
            "country_code": "US",
            "telephone_number": "925-685-4533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "MARTHA",
        "middle_name": "CARMELLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2022-09-25",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "endpointDescription": "n/a",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2123 Ygnacio Valley Rd Ste 200",
            "city": "Walnut Creek",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945983395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.