Individual provider Active NPI

Brett Wilson II, M.D.

  • Emergency Medicine Physician
  • Santa Barbara, CA
National Provider Identifier
1780601252
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A97199 Issued in CA
Practice address
300 W Pueblo St
Santa Barbara, CA 93105-4311
Phone
(805) 682-7111
Fax
(805) 569-8368
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD.026108 LA
Emergency Medicine Physician 207P00000X A97199 CA Primary

Addresses

Primary practice location

300 W Pueblo St
Santa Barbara, CA 93105-4311

Mailing address

PO Box 10040
Westminster, CA 92685-0040
Phone (562) 809-3528

Other identifiers 1

IdentifierTypeStateIssuer
00A971990MedicaidCA

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
I20070317000088 CA Practitioner - Emergency MedicinePractitioner - Physical Medicine and Rehabilitation 2860496486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Tulane University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Coast Emergency Medical Group IncGroup PAC ID 1355254269, 33 clinicians

Practice addresses (Care Compare)

400 W Pueblo St
Santa Barbara Cottage Hospital
Santa Barbara, CA 93105-4353
Phone (805) 682-7111

Hospital & facility affiliations

  • Santa Barbara Cottage Hospital Hospital, Santa Barbara, CA, CCN 050396
  • Goleta Valley Cottage Hospital Hospital, Santa Barbara, CA, CCN 050357
  • Santa Ynez Valley Cottage Hospital Hospital, Solvang, CA, CCN 051331

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as group
Quality
98.36
Promoting interoperability
100
Improvement activities
40
Cost
75.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.026108LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Emergency Medical Group Inc Emergency Medicine CurrentSince Feb 1, 2007 Accepting new patients
Cottage Medical Associates Past Accepting new patients

Locations

351 S Patterson Ave
Santa Barbara, CA 93111
Phone (805) 681-6406

400 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 569-7279

Organizations & group practices 2

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 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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270080000000",
    "number": "1780601252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10040",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926850040",
            "telephone_number": "562-809-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W PUEBLO ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931054311",
            "telephone_number": "805-682-7111",
            "fax_number": "805-569-8368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRETT",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD.026108",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A97199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A971990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.