LISHA LYNNE WILSON MD
NPI 1003809765
Internal Medicine in Oakland, CA

Active since August 29, 2005PECOS EnrolledAccepts Medicare Assignment
400 29TH ST, STE 501, OAKLAND, CA 94609(510) 268-1800(510) 268-1803 Get Directions Write a Review

NPPES record last updated: August 9, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lisha Lynne Wilson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISHA LYNNE WILSON MD (NPI 1003809765) is an individual internal medicine provider in Oakland, California, licensed in California (G73584) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS and is a graduate of Howard University College Of Medicine (1990).

NPPES Registry Identity

NPI1003809765
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameLISHA LYNNE WILSONCredential: MD
Location Address400 29TH ST, STE 501Oakland, CA 94609-3550
Mailing Address400 29th St, Ste 501Oakland, CA 94609-3550 · (510) 268-1800 · Fax (510) 268-1803
Fax(510) 268-1803
Sole ProprietorNo
Medical School CMSHoward University College Of MedicineGraduated 1990
Enumeration DateAugust 29, 2005
Last NPPES UpdateAugust 9, 2016
NPI 1003809765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in CA · G73584
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

400 29TH ST, Oakland, CA 94609

Other Identifiers 1

Medicare UPING00492

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Lisha Lynne Wilson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2961550454
PECOS Enrollment IDI20090512000156
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94609 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$153.83 typical visit price
range $69.00 – $202.35
Typical copayment $38.45 (range $17.25 – $50.58)
Most-billed visit code 99204
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
400 29TH ST, SUITE 502
OAKLAND, CA 94609
Acupuncturist
400 29TH ST, SUITE 419
OAKLAND, CA 94609
Acupuncturist
400 29TH ST, SUITE 317
OAKLAND, CA 94609
Durable Medical Equipment & Medical Supplies
400 29TH ST, SUITE 100
OAKLAND, CA 94609
Durable Medical Equipment & Medical Supplies
400 29TH ST, #208
OAKLAND, CA 94609
Durable Medical Equipment & Medical Supplies
400 29TH ST, SUITE #208
OAKLAND, CA 94609
Clinical Medical Laboratory
400 29TH ST, #208
OAKLAND, CA 94609
Acupuncturist
400 29TH ST, SUITE 403
OAKLAND, CA 94609

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisha Wilson's NPI number?

The NPI number for Lisha Wilson is 1003809765. It was assigned to this individual provider in the NPPES registry on August 29, 2005.

Where is Lisha Wilson located?

Lisha Wilson practices at 400 29th St Ste 501, Oakland, CA 94609. The listed phone number is (510) 268-1800.

What is Lisha Wilson's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Lisha Wilson enrolled in Medicare?

Yes. Lisha Wilson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Lisha Wilson was last updated on August 9, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.