Individual provider Active NPI

Alisa Lynn Williams MD, M.D.

  • Specialist
  • San Diego, CA
National Provider Identifier
1720006398
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
GG60944 Issued in CA
Practice address
5555 Reservoir Dr Ste 307
San Diego, CA 92120-5134
Phone
(619) 299-3111
Fax
(619) 299-3126
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X GG60944 CA Primary

Addresses

Primary practice location

5555 Reservoir Dr Ste 307
San Diego, CA 92120-5134

Mailing address

5555 Reservoir Dr Ste 307
San Diego, CA 92120-5134
Phone (619) 299-3111

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
I20090122000461 CA Practitioner - Obstetrics/Gynecology 8628979465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Tennessee, HSC, College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5555 Reservoir Dr
Suite 307
San Diego, CA 92120-5134
Phone (619) 299-3111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
GG60944CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Alisa L Williams, MD, Facog, Inc. Specialist CurrentSince Apr 1, 2008 Accepting new patients
Scripps Health PastSince Jan 5, 2020 Accepting new patients

Locations

4060 4th Ave
Ste 640
San Diego, CA 92103
Phone (619) 299-3111

5555 Reservoir Dr
Ste 307
San Diego, CA 92120
Phone (619) 299-3111

Interoperability endpoints

  • Direct secure messaging: awilliams28077@scrippshlth.medalliesdirect.net
  • Direct secure messaging: alisa.williams.1@3415.direct.athenahealth.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 and National Provider Directory roles.

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1720006398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR STE 307",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205134",
            "telephone_number": "619-299-3111",
            "fax_number": "619-299-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR STE 307",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205134",
            "telephone_number": "619-299-3111",
            "fax_number": "619-299-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS MD",
        "first_name": "ALISA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "GG60944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.