Individual provider Active NPI

William Michael Collins, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Davis, CA
National Provider Identifier
1417361973
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
20A15413 Issued in CA
Practice address
1955 Cowell Blvd
Davis, CA 95618-6325
Phone
(530) 757-7100
NPI assigned
Jun 12, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 20A15413 CA Primary

Addresses

Primary practice location

1955 Cowell Blvd
Davis, CA 95618-6325

Mailing address

1955 Cowell Blvd
Davis, CA 95618-6325
Phone (530) 757-7100

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

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
I20170818001344 CA Practitioner - Family PracticePractitioner - Sports Medicine 6406175918 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

1955 Cowell Blvd
Davis, CA 95618-6325
Phone (530) 757-4100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A15413CAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Sports Medicine CurrentSince Jul 2, 2017 Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Sep 19, 2018 Accepting new patients
Permanente Medical Group, Inc CurrentSince Feb 24, 2025 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Sep 19, 2018 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Feb 11, 2018 Accepting new patients
Permanente Medical Group Inc CurrentSince Feb 24, 2025 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Regents of the University of California CurrentSince Jul 2, 2017 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Feb 11, 2018 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

1955 Cowell Blvd
Davis, CA 95618
Phone (530) 757-7070

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

5525 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 644-6600

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

5820 Owens Dr
Bldg E
Pleasanton, CA 94588
Phone (925) 737-3785

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

4094 4th Ave
San Diego, CA 92103
Phone (619) 515-2545

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

3544 30th St
San Diego, CA 92104
Phone (619) 515-2424

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 10

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1417361973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 COWELL BLVD",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956186325",
            "telephone_number": "530-757-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 COWELL BLVD",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956186325",
            "telephone_number": "530-757-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A15413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1955 Cowell Blvd",
            "city": "Davis",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956186325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.