JACK M WILSON M.D.
NPI 1033125299
Emergency Medicine in San Diego, CA

Q: What is Jack Wilson's NPI number?

The NPI number for Jack Wilson is 1033125299. It was assigned to this individual provider in the NPPES registry on July 31, 2006.

Q: What is Jack Wilson's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Wilson was last updated on January 31, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 31, 2006PECOS EnrolledAccepts Medicare Assignment

6655 ALVARADO RD, SAN DIEGO, CA 92120(619) 229-3130 Get Directions Write a Review

NPPES record last updated: January 31, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 31, 2023, Mar 9, 2022 (2 updates tracked since 2022).

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About Jack M Wilson M.d. NPPES

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

JACK M WILSON M.D. (NPI 1033125299) is an individual emergency medicine provider in San Diego, California, licensed in California (G49906) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, San Diego School Of Medicine (1981).

NPPES Registry Identity

NPI1033125299

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameJACK M WILSONCredential: M.D.

Location Address6655 ALVARADO RDSan Diego, CA 92120-5208

Mailing Address2100 Powell St, Suite 900Emeryville, CA 94608-1826 · (510) 350-2777

Phone(619) 229-3130

Sole ProprietorNo

Medical School CMSUniversity Of California, San Diego School Of MedicineGraduated 1981

Enumeration DateJuly 31, 2006

Last NPPES UpdateJanuary 31, 20232 updates tracked since enumeration

NPPES CertifiedJanuary 31, 2023

✔ NPI 1033125299 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

Licenses✔ Licensed in CA · G49906✔ Licensed in MN · 2645✔ Licensed in NY · 320064

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

6655 ALVARADO RD, San Diego, CA 92120

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

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

Jack M Wilson M.d. 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 ID5395828974

PECOS Enrollment IDI20080206000397

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

52 services52 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

18 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92120 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

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$108.42 typical visit price

range $20.62 – $151.42

Typical copayment $27.10 (range $5.15 – $37.85)

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.

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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.

JENNIFER LEE HANLEY PA-C

Physician Assistant (Surgical)