Maritza Kathleen Wilson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A146931 Issued in CA

Practice address

728 E Valley Pkwy
Escondido, CA 92025-3052

Phone

(760) 737-6900

Fax

(360) 462-2748

NPI assigned

Apr 27, 2015

Last updated

Jun 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

East Tennessee State University Quillen College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neighborhood HealthcareGroup PAC ID 5294649406, 153 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Neighborhood Healthcare

  dba Neighborhood Healthcare - Escondido

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1598703647

  General Practice

  Medicare reassignment Care Compare group NPD
• Neighborhood Healthcare

  dba Neighborhood Healthcare - Beaumont

  • Federally Qualified Health Center (FQHC)
  • Beaumont, CA
  • NPI 1629601653

  General Practice

  NPD

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1720465925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 E VALLEY PKWY",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253052",
            "telephone_number": "760-737-6900",
            "fax_number": "360-462-2748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 E VALLEY PKWY",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253052",
            "telephone_number": "760-737-6900",
            "fax_number": "360-462-2748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARITZA",
        "middle_name": "KATHLEEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A146931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernest Randall Williamson, D.C.
• Dana Willis
• Kira Willis
• Casey Evan Wilson, M.D., M.P.H.
• Francelyn Estavillo Wilson, LVN
• Santenna Yvette Wilson, CADC-II
• Shamir Wilson
• Tristen Wilson
• Trevor Brian Wing I, MA
• Daniel Winston

• Family Medicine Physician in Escondido, CA
• Providers in Escondido, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.

Verify at the official NPI Registry.