Michael Lee Wynn, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

006398000 Issued in CA

Practice address

5601 Norris Canyon Rd
Ste 100
San Ramon, CA 94583-5407

Phone

(925) 277-1055

Fax

(925) 277-1915

NPI assigned

Jun 6, 2006

Last updated

Jun 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

General Surgery

Education

Irvine California College of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, shared by 16 NPIs, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Ramon Regional Medical Center Hospital, San Ramon, CA, CCN 050689

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwynn240919@hisp.ehr.sutterhealth.org

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.

• Sutter Bay Medical Foundation

  dba Palo Alto Medial Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  dba Palo Alto Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Palo Alto, CA
  • NPI 1104067115
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Fremont, CA
  • NPI 1497996524
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Los Altos, CA
  • NPI 1568851327
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Mountain View, CA
  • NPI 1982845186
  Medicare reassignment NPD
• Michael Lee Wynn MD Inc

  • Surgery Physician
  • San Ramon, CA
  • NPI 1336172741
  Authorized official Same address or phone
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • San Carlos, CA
  • NPI 1164840088
  NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Fremont, CA
  • NPI 1306241534
  NPD
• Sutter Bay Medical Foundation

  dba Palo Alto Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• John Muir Health

  • Rehabilitation Hospital Unit
  • Walnut Creek, CA
  • NPI 1447269303
  NPD (past)
• San Ramon Regional Medical Center, LLC

  • General Acute Care Hospital
  • San Ramon, CA
  • NPI 1932131489
  NPD (past)
• Stanford Health Care Tri-Valley

  • General Acute Care Hospital
  • Pleasanton, CA
  • NPI 1144389941
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• San Ramon Regional Medical Center, LLC

  • General Acute Care Hospital
  • San Ramon, CA
  • NPI 1932131489
  Care Compare affiliation

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1285673996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "925-277-1055",
            "fax_number": "925-277-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 NORRIS CANYON RD",
            "address_2": "STE 100",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945835407",
            "telephone_number": "925-277-1055",
            "fax_number": "925-277-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "006398000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delvin Wu, PHARM D
• Grace X Wu, D.D.S.
• Michael Martin Wu, PHARM.D.
• Mike Wu, DDS
• Nilufer Wumaier
• Xincare Wellness Center Inc.
• Makayla Xiong
• Omar Mohammad Yaacoobi, DMD
• Chelsey Yah
• Norman Yamada, PA

• Surgery Physician in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.