Individual provider Active NPI

Vanessa Valencia Wilson, M.D.

  • Internal Medicine Physician
  • Fremont, CA
National Provider Identifier
1992728620
Registry record updated Mar 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A049261 Issued in CA
Practice address
38719 Stivers St
Fremont, CA 94536-5337
Phone
(510) 248-1000
Fax
(510) 608-6055
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A049261 CA Primary

Addresses

Primary practice location

38719 Stivers St
Fremont, CA 94536-5337

Mailing address

39141 Civic Center Dr
Suite 130
Fremont, CA 94538-5818
Phone (510) 248-1680

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
I20080523000265 CA Practitioner - Internal Medicine 1951470418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington Township Medical FoundationGroup PAC ID 2860687050, 125 clinicians

Practice addresses (Care Compare)

39141 Civic Ctr Dr
Fremont, CA 94538-5878

39141 Civic Ctr Dr
Suite 130
Fremont, CA 94538-5831
Phone (510) 791-1005

39500 Fremont Blvd
Suite 100
Fremont, CA 94538-2101
Phone (510) 687-9510

Hospital & facility affiliations

  • Amore Home Health Home health agency, Fremont, CA, CCN 059509
  • American Home Health Care, LLC Home health agency, Dublin, CA, CCN 059145
  • Perpetual Care Home Health Home health agency, Milpitas, CA, CCN 059492
  • Sequoia Home Health Home health agency, Milpitas, CA, CCN 058496
  • Washington Hospital Hospital, Fremont, CA, CCN 050195
  • Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283

Merit-based Incentive Payment System (MIPS)

Final score
87.74 of 100Reported as group
Quality
66.48
Promoting interoperability
100
Improvement activities
40
Cost
75.97

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue423
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A049261CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Township Medical Foundation Internal Medicine CurrentSince Nov 1, 2010 Accepting new patients
Washington Township Medical Foundation CurrentSince Nov 1, 2010 Accepting new patients

Locations

39141 Civic Center Dr
Ste 130
Fremont, CA 94538
Phone (510) 248-1680

39500 Fremont Blvd
Ste 100
Fremont, CA 94538
Phone (510) 248-1800

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

2557 Mowry Ave
Ste 10
Fremont, CA 94538
Phone (510) 248-1843

680 Mowry Ave
Fremont, CA 94536
Phone (510) 790-1511

38719 Stivers St
Fremont, CA 94536
Phone (510) 400-5252

Interoperability endpoints

  • Direct secure messaging: vwilson7188@direct.whhs.com

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 6

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1992728620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39141 CIVIC CENTER DR",
            "address_2": "SUITE 130",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945385818",
            "telephone_number": "510-248-1680",
            "fax_number": "510-792-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38719 STIVERS ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365337",
            "telephone_number": "510-248-1000",
            "fax_number": "510-608-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "VANESSA",
        "middle_name": "VALENCIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A049261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.