Individual provider Active NPI

Jacqueline Carol Wilk, MD

  • Neonatal-Perinatal Medicine Physician
  • San Francisco, CA
National Provider Identifier
1528251840
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
C201834 Issued in CA
Practice address
1975 4TH St FL 3
San Francisco, CA 94143-2351
Phone
(415) 353-1565
NPI assigned
Aug 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X MD29023 OR
Neonatal-Perinatal Medicine Physician 2080N0001X MD29023 OR
Pediatrics Physician 208000000X C201834 CA
Neonatal-Perinatal Medicine Physician 2080N0001X C201834 CA Primary

Addresses

Primary practice location

1975 4TH St FL 3
San Francisco, CA 94143-2351

Mailing address

1208 Beall LN
Central Point, OR 97502-1573
Phone (541) 664-5151

Other practice location 1

350 Rhode Island St Ste 200
San Francisco, CA 94103-5188
Phone (415) 600-6240

Other identifiers 2

IdentifierTypeStateIssuer
201834OtherCAMEDICAL LICENSE
MD29023OtherORMEDICAL LICENSE

Other names 1

  • Jacqueline Lucas Other name

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 OR, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161114001147 OR Practitioner - Pediatric Medicine 3870872997 Reassigns benefits to 1 organization
I20260526003014 CA Practitioner - Pediatric Medicine 3870872997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

325 Distel Cir
Los Altos, CA 94022-1408

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C201834CAMDNeonatal-Perinatal Medicine Physician
MD29023ORMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asante Physician Partners Pediatrics CurrentSince Oct 4, 2016 Accepting new patients

Locations

625 SW Ramsey Ave
Ste A
Grants Pass, OR 97527
Phone (541) 474-5004

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

2620 E Barnett Rd
Ste H
Medford, OR 97504
Phone (541) 789-4281

Organizations & group practices 2

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": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1528251840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 BEALL LN",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975021573",
            "telephone_number": "541-664-5151",
            "fax_number": "541-664-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 4TH ST FL 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432351",
            "telephone_number": "415-353-1565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Rhode Island St Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941035188",
            "country_code": "US",
            "telephone_number": "415-600-6240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILK",
        "first_name": "JACQUELINE",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-21",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "OR",
            "license": "MD29023",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OR",
            "license": "MD29023",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C201834",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "C201834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "201834",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD29023",
            "state": "OR"
        }
    ],
    "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": "350 Rhode Island St Ste 200",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941035188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "LUCAS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.