Tim Jack Wilkins, CAADAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

707 Fair Ave
Santa Cruz, CA 95060-5828

Phone

(831) 427-1007

NPI assigned

Jul 18, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1437314416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 FAIR AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950605828",
            "telephone_number": "831-427-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 FAIR AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950605828",
            "telephone_number": "831-427-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "TIM",
        "middle_name": "JACK",
        "credential": "CAADAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-18",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A2007706",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "N3434433",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "19000 Homestead Rd",
            "city": "Cupertino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950140712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tracy L Wikander, MFT
• Ralph Wilcox III, CADC
• Eleanor Kay Wilder, LMFT
• Michael Gene Wiley, MA, MFT
• Gina L Wilhelm, CAADE
• Spencer I Wilkinson
• Amy Erin Williams-McNish, M.A., LMFT #103875
• Amanda Williams
• Amber Williams
• Amy Williams

• Addiction (Substance Use Disorder) Counselor in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.