Individual provider Active NPI

Connor L Wiles, MD

  • Surgery Physician
  • Bishop, CA
National Provider Identifier
1285130724
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A174969 Issued in CA
Practice address
152 Pioneer LN
Bishop, CA 93514-2563
Phone
(760) 872-1606
NPI assigned
Apr 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TL.0006980 CO
Surgery Physician 208600000X A174969 CA Primary

Addresses

Primary practice location

152 Pioneer LN
Bishop, CA 93514-2563

Mailing address

150 Pioneer LN
Bishop, CA 93514-2556
Phone (760) 873-5811

Other practice location 1

12605 E 16th Ave
Aurora, CO 80045-2545
Phone (720) 848-0000

Other practice location 2

400 W Pueblo St
Santa Barbara, CA 93105-4353
Phone (805) 722-7894

Other names 1

  • Dr. Connor L Wiles Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230808001497 CA Practitioner - General Surgery 4981950342 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Oregon Health Sciences University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Inyo Healthcare DistrictGroup PAC ID 8921992090, 104 clinicians

Practice addresses (Care Compare)

152 Pioneer LN
Suite G
Bishop, CA 93514-2563
Phone (760) 872-1606

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A174969CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Inyo Healthcare District CurrentSince Aug 14, 2023 Accepting new patients
Northern Inyo Healthcare District Current Accepting new patients

Locations

152 Pioneer Ln
Bishop, CA 93514
Phone (619) 873-7111

152 Pioneer Ln
Ste F
Bishop, CA 93514
Phone (760) 872-1606

152 Pioneer Ln
Ste G
Bishop, CA 93514
Phone (619) 872-2244

150 Pioneer Ln
Bishop, CA 93514
Phone (760) 873-2136

Organizations & group practices 2

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.

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": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1285130724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PIONEER LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142556",
            "telephone_number": "760-873-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 PIONEER LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142563",
            "telephone_number": "760-872-1606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12605 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452545",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W Pueblo St",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "931054353",
            "country_code": "US",
            "telephone_number": "805-722-7894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILES",
        "first_name": "CONNOR",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL.0006980",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A174969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNOR",
            "last_name": "WILES",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bishop, CA

Sources for this page

Verify at the official NPI Registry.