Individual provider Active NPI

Matthew D Wilson, DPM

  • Podiatrist
  • San Diego, CA
National Provider Identifier
1699138891
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E5700 Issued in CA
Practice address
5555 Reservoir Dr Ste 104
San Diego, CA 92120-5198
Phone
(619) 286-9480
Fax
(619) 286-4568
NPI assigned
Apr 4, 2016
Last updated
Mar 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E5700 CA Primary

Addresses

Primary practice location

5555 Reservoir Dr Ste 104
San Diego, CA 92120-5198

Mailing address

5555 Reservoir Dr Ste 104
San Diego, CA 92120-5198
Phone (619) 286-9480

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200908001405 CA Practitioner - Podiatry 5698069276 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alvarado Orthopedic Medical Group IncGroup PAC ID 9032022314, 8 clinicians

Practice addresses (Care Compare)

5555 Reservoir Dr
Suite 104
San Diego, CA 92120-5198
Phone (619) 286-9480

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
73.04
Improvement activities
40
Cost
83.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5700CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Oct 24, 2020 Accepting new patients
Alvarado Orthopedic Medical Group, Inc. CurrentSince Sep 1, 2020 Accepting new patients
Sharp Coronado Hospital and Healthcare Center Past Accepting new patients
Center for Orthopedic Research and Education, LLC Podiatrist Past Accepting new patients
X-Ray Medical Group Inc PastSince Sep 1, 2020 Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

8860 Center Dr
Ste 350
La Mesa, CA 91942
Phone (619) 258-8552

5555 Reservoir Dr
Ste 104
San Diego, CA 92120
Phone (619) 286-9480

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

Interoperability endpoints

  • Direct secure messaging: mwilson32712@sharphealthcare.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1699138891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR STE 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205198",
            "telephone_number": "619-286-9480",
            "fax_number": "619-286-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR STE 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205198",
            "telephone_number": "619-286-9480",
            "fax_number": "619-286-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.