Individual provider Active NPI

Michael Leon Wilson, DPM

  • Podiatrist
  • Chico, CA
National Provider Identifier
1992792774
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4344 Issued in CA
Practice address
2103 Forest Ave
Chico, CA 95928-7680
Phone
(530) 895-3668
Fax
(503) 895-0927
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4344 CA Primary

Addresses

Primary practice location

2103 Forest Ave
Chico, CA 95928-7680

Mailing address

2103 Forest Ave
Chico, CA 95928-7680
Phone (530) 895-3668

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070330000620 CA Practitioner - Podiatry 0345344339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chico Podiatry GroupGroup PAC ID 3072617067, 3 clinicians

Practice addresses (Care Compare)

2103 Forest Ave
Chico, CA 95928-7680
Phone (530) 895-3668

Merit-based Incentive Payment System (MIPS)

Final score
80 of 100Reported as group
Quality
60
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue118
Removal of skin lesions1-10
Removal of nail tissue1241
Removal or shaving of skin growth469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4344CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Chico Podiatry Group Podiatrist CurrentSince Aug 1, 2001 Accepting new patients

Locations

2103 Forest Ave
Chico, CA 95928
Phone (530) 895-3668

Interoperability endpoints

  • Direct secure messaging: mwilson15510@enloedirect.org

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1992792774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 FOREST AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959287680",
            "telephone_number": "530-895-3668",
            "fax_number": "503-895-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 FOREST AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959287680",
            "telephone_number": "530-895-3668",
            "fax_number": "503-895-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHAEL",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.