Individual provider Active NPI

Elisa Anne Wilson, MD, MPH

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1972716918
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A121098 Issued in CA
Practice address
501 Washington St
San Diego, CA 92103-2231
Phone
(619) 849-4490
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
No

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
Family Medicine Physician 207Q00000X A121098 CA Primary

Addresses

Primary practice location

501 Washington St
San Diego, CA 92103-2231

Mailing address

10790 Rancho Bernardo Rd # 4S-205
San Diego, CA 92127-5705
Phone (858) 927-5775

Other practice location 1

15464 Goldenwest St
Westminster, CA 92683-6149
Phone (714) 891-9008

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
I20120917000604 CA Practitioner - Family Practice 4385790963 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

111 Campus Way
Suite 301
San Marcos, CA 92078-4212
Phone (760) 806-5700

2176 Salk Ave
Carlsbad, CA 92008-7346
Phone (760) 827-7200

2205 Vista Way
Oceanside, CA 92054-5661

4318 Mission Ave
Oceanside, CA 92057-6541
Phone (760) 901-5100

501 Washington St
San Diego, CA 92103-2239
Phone (619) 278-3300

971 Lane Ave
Chula Vista, CA 91914-3501
Phone (619) 502-7300

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9896 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A121098CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health CurrentSince Sep 5, 2017 Accepting new patients
Scripps Health Family Medicine CurrentSince Sep 5, 2017 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Current Accepting new patients
Memorialcare Medical Foundation Family Medicine CurrentSince Aug 1, 2017 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Family Medicine Current Accepting new patients
Portland Family Practice Inc. Family Medicine PastSince Jan 5, 2009 Accepting new patients
Portland Clinic Family Medicine Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients
Scripps Health Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Children'S Hospital of Orange County Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients

Locations

15 Mareblu
Ste 100
Aliso Viejo, CA 92656
Phone (949) 448-0656

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

9122 Adams Ave
Huntington Beach, CA 92646
Phone (714) 378-0900

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

501 Washington St
Ste 600
San Diego, CA 92103
Phone (619) 278-3300

10790 Rancho Bernardo Rd
#4S205
San Diego, CA 92127
Phone (858) 605-7171

501 Washington St
San Diego, CA 92103
Phone (619) 278-3300

15464 Goldenwest St
Westminster, CA 92683
Phone (714) 891-9008

Interoperability endpoints

  • Direct secure messaging: ewilson37317@scrippshlth.medalliesdirect.net

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 2

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1972716918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD # 4S-205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-927-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032231",
            "telephone_number": "619-849-4490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15464 Goldenwest St",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "CA",
            "postal_code": "926836149",
            "country_code": "US",
            "telephone_number": "714-891-9008",
            "fax_number": "714-897-7949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ELISA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A121098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.