Individual provider Active NPI

Mary Ellen Wilkosz, FNP

  • Family Nurse Practitioner
  • Novato, CA
National Provider Identifier
1457565814
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
N378008 Issued in CA
Practice address
165 Rowland Way #105
Novato, CA 94945
Phone
(415) 897-2776
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X N378008 CA Primary

Addresses

Primary practice location

165 Rowland Way #105
Novato, CA 94945

Mailing address

469 Estado Way
Novato, CA 94945-1327
Phone (415) 892-2244

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050721000287 CA Practitioner - Nurse Practitioner 4981631983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Regents Univ of California UCSFGroup PAC ID 6305160300, 276 clinicians

Practice addresses (Care Compare)

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

Hospital & facility affiliations

  • Novato Community Hospital Hospital, Novato, CA, CCN 050131
  • Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360

Merit-based Incentive Payment System (MIPS)

Final score
81.03 of 100Reported as subgroup
Quality
80.86
Promoting interoperability
76
Improvement activities
40
Cost
75.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
N378008CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents Univ of California UCSF CurrentSince Nov 1, 2018 Accepting new patients

Locations

165 Rowland Way
Ste 215
Novato, CA 94945
Phone (415) 897-5171

75 Rowland Way
Ste 200
Novato, CA 94945
Phone (415) 897-3174

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

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

4000 Civic Center Dr
Ste 205
San Rafael, CA 94903
Phone (415) 479-7244

Interoperability endpoints

  • Direct secure messaging: mwilkosz240396@hisp.ehr.sutterhealth.org
  • Direct secure messaging: mwilkosz106604@direct-ucsfmedicalcenter.org

Organizations & group practices 1

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 2

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1457565814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 ESTADO WAY",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949451327",
            "telephone_number": "415-892-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 ROWLAND WAY #105",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "94945",
            "telephone_number": "415-897-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKOSZ",
        "first_name": "MARY ELLEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "N378008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

Verify at the official NPI Registry.