Individual provider Active NPI

Elizabeth Collens Wick, MD

  • Surgery Physician
  • Baltimore, MD
National Provider Identifier
1316075997
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D67913 Issued in MD
Practice address
600 N Wolfe St
Blalock 658
Baltimore, MD 21287-0005
Phone
(410) 955-7323
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A76824 CA
Surgery Physician 208600000X D67913 MD Primary

Addresses

Primary practice location

600 N Wolfe St
Blalock 658
Baltimore, MD 21287-0005

Mailing address

PO Box 64563
Baltimore, MD 21264-4563

Other identifiers 1

IdentifierTypeStateIssuer
415768100MedicaidMD

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
I20160815000076 CA Practitioner - Colorectal Surgery (Proctology) 6507934502 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Vanderbilt University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCSF Dept of SurgeryGroup PAC ID 7719886373, 211 clinicians

Practice addresses (Care Compare)

400 Pamassus Ave
San Francisco, CA 94143-0001
Phone (415) 476-1316

Hospital & facility affiliations

  • UCSF Medical Center Hospital, San Francisco, CA, CCN 050454

Merit-based Incentive Payment System (MIPS)

Final score
97.51 of 100Reported as group
Quality
92.74
Improvement activities
40
Cost
72.4

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76824CAMDClinical Social Worker
A76824CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jul 1, 2016 Accepting new patients
University of California San Francisco CurrentSince Jul 1, 2016 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 1, 2016 Accepting new patients
University of California San Francisco Current Accepting new patients
University of California San Francisco Surgery CurrentSince Jul 1, 2016 Accepting new patients
UCSF Dept of Surgery Surgery CurrentSince Jul 1, 2016 Accepting new patients
UCSF Medical Group Business Services Surgery CurrentSince Jul 1, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

1825 4th St
#4
San Francisco, CA 94143

1825 4th St
#M4204
San Francisco, CA 94143

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

1825 4th St
Ste PCMB4
San Francisco, CA 94143

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

Organizations & group practices 9

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1316075997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64563",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "address_2": "BLALOCK 658",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-7323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICK",
        "first_name": "ELIZABETH",
        "middle_name": "COLLENS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A76824",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D67913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "415768100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.