Individual provider Active NPI

Elizabeth Scott Wasson, MD

  • Internal Medicine Physician
  • Saint Helena, CA
National Provider Identifier
1679755045
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A126381 Issued in CA
Practice address
10 Woodland Rd
Saint Helena, CA 94574-9554
Phone
(707) 963-6399
Fax
(707) 967-5915
NPI assigned
Nov 28, 2007
Last updated
Oct 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X A126381 CA
Geriatric Medicine (Family Medicine) Physician 207QG0300X A126381 CA
Internal Medicine Physician 207R00000X A126381 CA Primary

Addresses

Primary practice location

10 Woodland Rd
Saint Helena, CA 94574-9554

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

Other identifiers 2

IdentifierTypeStateIssuer
300432OtherCABOARD CERTIFICATION-INTERNAL MEDICINE
A126381OtherCAPHYSICIAN AND SURGEON

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
I20150126001322 CA Practitioner - Internal MedicinePractitioner - Hospitalist 5991847667 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A126381CAMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince Aug 1, 2015 Accepting new patients
24 On Physicians of California, PC CurrentSince Jun 15, 2015 Accepting new patients
Superior Hospitalist Medical Group Inc Internal Medicine CurrentSince Dec 1, 2016 Accepting new patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Dec 1, 2016 Accepting new patients

Locations

2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655

1415 Ross Ave
El Centro, CA 92243
Phone (760) 339-4045

2700 Dolbeer St
Eureka, CA 95501
Phone (707) 269-4229

1680 E 120th St
Los Angeles, CA 90059
Phone (424) 338-8000

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

10 Woodland Rd
Saint Helena, CA 94574
Phone (707) 261-7821

450 Stanyan St
San Francisco, CA 94117
Phone (415) 668-1000

300 Hospital Dr
Vallejo, CA 94589
Phone (707) 554-4107

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507766400000",
    "number": "1679755045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WOODLAND RD",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749554",
            "telephone_number": "707-963-6399",
            "fax_number": "707-967-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSON",
        "first_name": "ELIZABETH",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2017-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A126381",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A126381",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A126381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD CERTIFICATION-INTERNAL MEDICINE",
            "identifier": "300432",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN AND SURGEON",
            "identifier": "A126381",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Helena, CA

Sources for this page

Verify at the official NPI Registry.