NPIMap

Individual provider Active NPI

Michael A. Wilson, M.D.

  • Internal Medicine Physician
  • Redlands, CA
National Provider Identifier
1740229293
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G75159 Issued in CA
Practice address
1600 E Citrus Ave
Ste a
Redlands, CA 92374-4270
Phone
(909) 794-3682
Fax
(909) 796-4158
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G75159 CA Primary

Addresses

Primary practice location

1600 E Citrus Ave
Ste a
Redlands, CA 92374-4270

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other identifiers 1

IdentifierTypeStateIssuer
00G751591MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060323000486 CA Practitioner - Internal Medicine 8123035920 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loma Linda University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beaver Medical Group P CGroup PAC ID 0547164295, 251 clinicians

Practice addresses (Care Compare)

2 W Fern Ave
Redlands, CA 92373-5916
Phone (909) 793-3311

Hospital & facility affiliations

  • Bridge Home Health Home health agency, Ontario, CA, CCN 559063
  • Mission Home Health of Ontario, Inc Home health agency, Ontario, CA, CCN 559309
  • Redlands Community Hospital Home Health Care Services Home health agency, Redlands, CA, CCN 057494
  • Med Care Plus Home Health Inc Home health agency, Pasadena, CA, CCN 058155
  • Redlands Community Hospital Hospital, Redlands, CA, CCN 050272
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

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
G75159CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cassidy Medical Group Inc. Current Accepting new patients
Beaver Medical Group P C CurrentSince Jan 25, 2006 Accepting new patients
Beaver Medical Group P C Internal Medicine CurrentSince Jan 25, 2006 Accepting new patients
Centers for Family Medicine GP Internal Medicine Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Feb 1, 2026 Accepting new patients
Healthcare Partners Affiliates Medical Group Internal Medicine CurrentSince Feb 1, 2026 Accepting new patients
Redlands Community Hospital Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Beaver Medical Group P C Internal Medicine Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

1600 E Citrus Ave
Ste A
Redlands, CA 92374
Phone (909) 294-3682

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

145 Thunder Dr
Vista, CA 92083
Phone (760) 630-5487

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mwilson11212@epiclp.direct-ci.com

Organizations & group practices 9

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 8

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1740229293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E CITRUS AVE",
            "address_2": "STE A",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744270",
            "telephone_number": "909-794-3682",
            "fax_number": "909-796-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G75159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G751591",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.