Active NPI
Michael J Wilcox, M.D.
- Internal Medicine Physician
- Walla Walla, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD00034335
- Practice address
- 55 W Tietan St
Walla Walla, WA 99362-4445 - Phone
- (509) 525-3720
- Fax
- (509) 522-1588
- NPI assigned
- Feb 16, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD00034335 | WA | Primary |
Addresses
Primary practice location
55 W Tietan St
Walla Walla, WA 99362-4445
Mailing address
55 W Tietan St
Walla Walla, WA 99362-4445
Phone (509) 525-3720
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 072954 | Medicaid | OR | |
| 8195224 | Medicaid | WA | |
| 110176 | Other | WA | L&I |
| 110127377 | Other | WA | RAIL ROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Oregon Health Sciences University School of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
55 W Tietan St
Walla Walla, WA 99362-4445
Phone 50952537201405
Hospital & facility affiliations
- Columbia River Home Health
- Providence at Home With Compassus Home Health, Walla Walla
- Providence St Mary Medical Center
- Dayton General Hospital
- St Anthony Hospital
- Kadlec Regional Medical Center
- Good Shepherd Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00034335 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walla Walla Clinic, Inc. | Current | Accepting new patients |
Locations
55 W Tietan St
Walla Walla, WA 99362
Phone (509) 525-3720
Interoperability endpoints
- michael.wilcox.1@28594.direct.athenahealth.com
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Walla Walla Clinic | Rural health clinic | General Partnership Interest | Nov 19, 2007 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Rural Health Clinic/Center
- Walla Walla, WA
- NPI 1346441979
General Partnership Interest
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.
-
- Clinic/Center
- Walla Walla, WA
- NPI 1780658419
-
- Ambulatory Surgical Clinic/Center
- Walla Walla, WA
- NPI 1760568273
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Dayton, WA
- NPI 1134128911
-
- Home Health Agency
- Walla Walla, WA
- NPI 1730901745
-
- Home Health Agency
- Kennewick, WA
- NPI 1699263079
-
- General Acute Care Hospital
- Richland, WA
- NPI 1972507580
-
- General Acute Care Hospital
- Walla Walla, WA
- NPI 1386895886
-
- Critical Access Hospital
- Pendleton, OR
- NPI 1649276734
-
- Critical Access Hospital
- Hermiston, OR
- NPI 1295789667
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196121600000",
"number": "1881668655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 W TIETAN ST",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993624445",
"telephone_number": "509-525-3720",
"fax_number": "509-522-1592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 W TIETAN ST",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993624445",
"telephone_number": "509-525-3720",
"fax_number": "509-522-1588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOX",
"first_name": "MICHAEL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-16",
"last_updated": "2007-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD00034335",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "072954",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8195224",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "110176",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "110127377",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.