Individual provider Active NPI

Wynnson W Tom, M.D.

  • Anesthesiology Physician
  • Orange, CA
National Provider Identifier
1902128028
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A101740 Issued in CA
Practice address
2601 E Chapman Ave
Orange, CA 92869-3206
Phone
(714) 633-0011
Fax
(714) 633-2238
NPI assigned
Feb 16, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A101740 CA Primary

Addresses

Primary practice location

2601 E Chapman Ave
Orange, CA 92869-3206

Mailing address

400 N. Tustin Ave
Suite 400
Santa Ana, CA 92705-3850
Phone (714) 560-1580

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
I20101025000797 CA Practitioner - Anesthesiology 6406049246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of California, San Francisco School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orange Coast Anesthesia IncGroup PAC ID 2466613591, 85 clinicians

Practice addresses (Care Compare)

2601 E Chapman Ave
Orange, CA 92869-3206
Phone (714) 633-0011

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101740CAMDGeneral Practice Dentistry
A101740CAMDAnesthesiology Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1266278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1902128028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N. TUSTIN AVE",
            "address_2": "SUITE 400",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053850",
            "telephone_number": "714-560-1580",
            "fax_number": "770-701-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928693206",
            "telephone_number": "714-633-0011",
            "fax_number": "714-633-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOM",
        "first_name": "WYNNSON",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A101740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.