MARY A. WILSON CRNA
NPI 1770599615
Nurse Anesthetist, Certified Registered in Rancho Cucamonga, CA
About Mary A. Wilson Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY A. WILSON CRNA (NPI 1770599615) is an individual nurse anesthetist, certified registered in Rancho Cucamonga, California, licensed in California (NA 2575) and active in the NPI registry since July 2006. She is a graduate of Other (1999).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mary A. Wilson Crna 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.
Medicare Billing Reassignments
2Medicare enrollment records show Mary Wilson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fontana, CA 92336
- Reassigned Medicare billing, California enrollment
- 5,228 clinicians in this Medicare group
Colton, CA 92324
- Reassigned Medicare billing, California enrollment
- 13 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91730 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
RANCHO CUCAMONGA, CA 91730
RANCHO CUCAMONGA, CA 91730
RANCHO CUCAMONGA, CA 91730
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 Mary Wilson's NPI number?
The NPI number for Mary Wilson is 1770599615. It was assigned to this individual provider in the NPPES registry on July 31, 2006.
Where is Mary Wilson located?
Mary Wilson practices at 10841 White Oak Ave, Rancho Cucamonga, CA 91730. The listed phone number is (909) 581-6400.
What is Mary Wilson's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Mary Wilson enrolled in Medicare?
Yes. Mary 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.
Which organizations bill Medicare for Mary Wilson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Wilson reassigns Medicare benefits to 2 organizations: Southern California Permanente Medical Group (Fontana, CA) and (Colton, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mary Wilson was last updated on December 2, 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.
# Mary A. Wilson, CRNA · NPI 1770599615
Nurse Anesthetist, Certified Registered physician in Rancho Cucamonga, California. Individual provider, active in the CMS NPPES registry since July 31, 2006.
## Identity
- **NPI:** 1770599615 (Entity type: Individual)
- **Enumerated:** July 31, 2006
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** NA 2575 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 10841 WHITE OAK AVE, Rancho Cucamonga, CA 91730-3817
- **Phone:** (909) 581-6400 · **Fax:** (909) 581-6418
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Southern California Permanente Medical Group (NPI 1316463763, Fontana, CA); (NPI 1104832039, Colton, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1999
## Record status
- **NPPES last updated:** December 2, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1770599615) · Data from the CMS NPPES public registry.