Julie A Wissink, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G66832 Issued in CA

Practice address

805 El Camino Real Ste B
Palo Alto, CA 94301-2315

Phone

(650) 329-0440

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 8, 2016 through Feb 8, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: julie.wissink@101989220356.direct.elationemr.com

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.

• Imgpa, Inc.

  • Internal Medicine Physician
  • Palo Alto, CA
  • NPI 1538229240
  NPD
• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1386738623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 EL CAMINO REAL STE B",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012315",
            "telephone_number": "650-329-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 EL CAMINO REAL STE B",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012315",
            "telephone_number": "650-329-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSINK",
        "first_name": "JULIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G66832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Julie.Wissink@101989220356.direct.elationemr.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "805 El Camino Real Ste B",
            "city": "Palo Alto",
            "state": "CA",
            "country_code": "US",
            "postal_code": "943012315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jody Winzelberg, AU.D.
• Budi Wiryawan, MD
• Bethany Layne Wiseman, AU.D.
• Clay Prescott Wiske, MD, MBA, MPHIL
• Thomas Wisler, M.D.
• Alan Witbeck, RRT
• Lauren Witcoff, M.D.
• Amanda D Withrow, PH.D.
• Anania Girma Woldetensaye, MD
• Libby Wolf, ACNP-BC

• Internal Medicine Physician in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.