Active NPI
Bernard R Wilcosky, M.D.
- Pain Medicine (Anesthesiology) Physician
- San Carlos, CA
National Provider Identifier
1780761247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- G048990
- Practice address
- 1016 Laurel St
San Carlos, CA 94070-3919 - Phone
- (650) 368-7246
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | G048990 | CA | Primary |
Addresses
Primary practice location
1016 Laurel St
San Carlos, CA 94070-3919
Mailing address
801 Brewster Ave
#945
Redwood City, CA 94063-1557
Phone (650) 368-7246
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G048990 | CA | MD | Pain Medicine (Anesthesiology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433721600000",
"number": "1780761247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 BREWSTER AVE",
"address_2": "#945",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940631557",
"telephone_number": "650-368-7246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1016 LAUREL ST",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940703919",
"telephone_number": "650-368-7246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOSKY",
"first_name": "BERNARD",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2015-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "CA",
"license": "G048990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Carlos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.