Individual provider Active NPI

Tiffany D Wilson, M.D.

  • Family Medicine Physician
  • Irvine, CA
National Provider Identifier
1700877057
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A70066 Issued in CA
Practice address
37 Creek Rd Ste 140
Irvine, CA 92604-4724
Phone
(949) 559-4480
Fax
(949) 262-7072
NPI assigned
Nov 3, 2005
Last updated
Feb 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A70066 CA Primary

Addresses

Primary practice location

37 Creek Rd Ste 140
Irvine, CA 92604-4724

Mailing address

PO Box 1744
Suisun City, CA 94585-4744
Phone (657) 241-3600

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
I20040416000306 CA Practitioner - Family Practice 9537154091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4950 Barranca Pkwy
Suite 308
Irvine, CA 92604-4631
Phone (949) 559-4480

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A70066CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tiffany Dawn Wilson, M.D., Inc. Family Medicine CurrentSince Jul 1, 2003 Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Tiffany Dawn Wilson, M.D., Inc. Internal Medicine Past Accepting new patients

Locations

37 Creek Rd
Bldg A
Irvine, CA 92604
Phone (949) 559-4480

37 Creek Rd
Ste 140
Irvine, CA 92604
Phone (949) 559-4480

4950 Barranca Pkwy
Ste 201
Irvine, CA 92604
Phone (949) 559-4480

4950 Barranca Pkwy
Ste 308
Irvine, CA 92604
Phone (949) 561-0700

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: tiffany.wilson.p55@direct.nautilus.nextgenshare.com

Organizations & group practices 3

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 1

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1700877057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1744",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945854744",
            "telephone_number": "657-241-3600",
            "fax_number": "657-241-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 CREEK RD STE 140",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044724",
            "telephone_number": "949-559-4480",
            "fax_number": "949-262-7072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TIFFANY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A70066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.