Constance Ruth Wylie

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP7089 Issued in CA

Practice address

1100 Van Ness Ave
San Francisco, CA 94109-6978

Phone

(415) 600-1010

Fax

(415) 558-7051

NPI assigned

Oct 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Connie Ruth Wylie Other name

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

Specialty

Nurse Practitioner

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108
• Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Sutter Bay Medical Foundation

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

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1003267196
  NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Regents of the Univ of Ca

  • Surgery Physician
  • Sacramento, CA
  • NPI 1427041698
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)

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

• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Roseville, CA
  • NPI 1356390264
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  Care Compare affiliation

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1376630814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21300 BALD RIDGE DR",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "959469402",
            "telephone_number": "530-304-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 VAN NESS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941096978",
            "telephone_number": "415-600-1010",
            "fax_number": "415-558-7051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Spanos Ct Ste 125",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953552814",
            "country_code": "US",
            "telephone_number": "916-732-4380",
            "fax_number": "415-558-7051",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1601 Esplanade Ste 3",
            "address_purpose": "LOCATION",
            "city": "Chico",
            "state": "CA",
            "postal_code": "959263370",
            "country_code": "US",
            "telephone_number": "415-600-1020",
            "fax_number": "415-600-1005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1315 Alhambra Blvd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958165246",
            "country_code": "US",
            "telephone_number": "916-732-4380",
            "fax_number": "916-739-0893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "CONSTANCE",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP7089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "WYLIE",
            "middle_name": "RUTH",
            "prefix": "MS.",
            "credential": "FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Deborah Wyatt, M.D.
• Judith Lois Wyatt, MFT
• Marie Allison Wyatt
• Jennifer Susan Wygant, DO
• Susannah Mary Wyles, M.D. PHD
• Joshua Gordon Wylie, MA, LMFT
• Leah Christine Wylie, DPT
• Deborah Ann Wyman-Dixson, ACSW
• Molly Martine Wyman, MSW
• Elizabeth Wyndham, PA-C

• Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.