Kip R Wilkins, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

5315013798 Issued in MI

Practice address

4601 Dale Rd
1St Floor Suite 1A6, Department of Orthopaedics
Modesto, CA 95356-9718

Phone

(209) 735-6104

NPI assigned

May 22, 2007

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

Electronic endpoints 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

Specialty

Orthopedic SurgeryAlso: Sports Medicine

Education

Saint Louis University School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Redwood City, CA
  • NPI 1639252604

  Orthopaedic Surgery

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1235348228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 DALE RD",
            "address_2": "1ST FLOOR SUITE 1A6, DEPARTMENT OF ORTHOPAEDICS",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569718",
            "telephone_number": "209-735-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 DALE RD",
            "address_2": "1ST FLOOR SUITE 1A6, DEPARTMENT OF ORTHOPAEDICS",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569718",
            "telephone_number": "209-735-6104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "KIP",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5315013798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4601 Dale Rd",
            "city": "Modesto",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953569718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erika Marie Widergren
• David Wiebe, RN
• Wojciech Gregory Wierzbowski, MD
• Christopher L Wilcox
• Kimberly Wilkerson
• Caleb Richard Wilkinson
• Theresa Kathryn Wilksen, M.A.
• Brock Willenbrink
• Stephen Matthew Willey, PT
• Trinity Willey

• Orthopaedic Surgery Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.