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CARLIE JEANETTE WILKERSON P.A.
NPI 1376748095
Physician Assistant - Surgical in Santa Rosa, CA

Active since June 21, 2007PECOS EnrolledAccepts Medicare Assignment
990 SONOMA AVE STE 20, SANTA ROSA, CA 95404(707) 525-0696(707) 525-8404 Get Directions Write a Review

NPPES record last updated: December 30, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Carlie Jeanette Wilkerson P.a. NPPES

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

CARLIE JEANETTE WILKERSON P.A. (NPI 1376748095) is an individual surgical provider in Santa Rosa, California, licensed in California (PA19226) and active in the NPI registry since June 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1376748095
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameCARLIE JEANETTE WILKERSONCredential: P.A.
Location Address990 SONOMA AVE STE 20Santa Rosa, CA 95404-4813
Mailing Address990 Sonoma Ave Ste 20Santa Rosa, CA 95404-4813 · (707) 525-0696 · Fax (707) 525-8404
Phone(707) 525-0696
Fax(707) 525-8404
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateJune 21, 2007
Last NPPES UpdateDecember 30, 2021
✔ NPI 1376748095 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in CA · PA19226
990 SONOMA AVE STE 20, Santa Rosa, CA 95404
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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

Carlie Jeanette Wilkerson P.a. 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 ID9830285204
PECOS Enrollment IDI20071016000317
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.

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 Carlie Wilkerson's NPI number?

The NPI number for Carlie Wilkerson is 1376748095. It was assigned to this individual provider in the NPPES registry on June 21, 2007.

Where is Carlie Wilkerson located?

Carlie Wilkerson practices at 990 Sonoma Ave Ste 20, Santa Rosa, CA 95404. The listed phone number is (707) 525-0696.

What is Carlie Wilkerson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Carlie Wilkerson enrolled in Medicare?

Yes. Carlie Wilkerson 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 Carlie Wilkerson was last updated on December 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.