Active NPI
Jacqueline Carol Wilk, MD
- Neonatal-Perinatal Medicine Physician
- San Francisco, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- C201834
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201834 | Other | CA | MEDICAL LICENSE |
| MD29023 | Other | OR | MEDICAL LICENSE |
Other names 1
- Jacqueline Lucas
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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
| License | State | Type | Specialty |
|---|---|---|---|
| C201834 | CA | MD | Neonatal-Perinatal Medicine Physician |
| MD29023 | OR | MD | Pediatric Critical Care Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Asante Physician Partners | Pediatrics | Current | 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.
-
dba Palo Alto Medial Foundation
- Multi-Specialty Clinic/Center
- Palo Alto, CA
- NPI 1013950807
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.