Individual provider Active NPI

Wilbert Francis Williams, PA-C

  • Physician Assistant
  • Long Beach, CA
National Provider Identifier
1295822534
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15780 Issued in CA
Practice address
5901 E 7TH St
Long Beach, CA 90822-5201
Phone
(562) 826-8000
Fax
(562) 826-5542
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15780 CA Primary

Addresses

Primary practice location

5901 E 7TH St
Long Beach, CA 90822-5201

Mailing address

4440 E Bainbridge Cir
Anaheim, CA 92807-2908
Phone (714) 921-4643

Other identifiers 1

IdentifierTypeStateIssuer
15780OtherCACALIFORNIA STATE LICENSE

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
I20211028002912 CA Practitioner - Physician Assistant 5698163350 Reassigns benefits to 1 organization

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: wilbert.williams@3856.securemail.prognocis.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295822534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 E BAINBRIDGE CIR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928072908",
            "telephone_number": "714-921-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 E 7TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908225201",
            "telephone_number": "562-826-8000",
            "fax_number": "562-826-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "WILBERT",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "15780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE LICENSE",
            "identifier": "15780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.