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MARIA THERESA LICERALDE WYSON MSN, FNP-C
NPI 1861769648
Nurse Practitioner - Family in Elk Grove, CA

Active since November 22, 2011PECOS Enrolled
7811 LAGUNA BLVD STE 161, ELK GROVE, CA 95758(916) 877-7778(916) 896-1286 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 7, 2023, Oct 1, 2021 (2 updates tracked since 2021).

About Maria Theresa Liceralde Wyson Msn, Fnp-c NPPES

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

MARIA THERESA LICERALDE WYSON MSN, FNP-C (NPI 1861769648) is an individual family provider in Elk Grove, California, licensed in California (21360) and active in the NPI registry since November 2011. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1861769648
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMARIA THERESA LICERALDE WYSONCredential: MSN, FNP-C
Location Address7811 LAGUNA BLVD STE 161Elk Grove, CA 95758-7949
Mailing Address11592 Linday WayGold River, CA 95670-6233 · (916) 213-2570
Phone(916) 877-7778
Fax(916) 896-1286
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateNovember 22, 2011
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
NPPES CertifiedOctober 1, 2021
✔ NPI 1861769648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 21360
7811 LAGUNA BLVD STE 161, Elk Grove, CA 95758
Open in Google Maps ↗

Other Names 1

Former Name (1)Maria Theresa Sideco Liceralde

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maria Theresa Liceralde Wyson Msn, Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2062637309
PECOS Enrollment IDI20200914001274
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 8

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 moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
66 services66 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
61 services53 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
36 services31 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
32 services32 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
29 services27 patients
X-ray of chest, 2 views 71046
A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
22 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95758 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
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

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

KRISTINE GRACE DELA CRUZ VAN TASSEL FNP-C
Nurse Practitioner (Family)
7811 LAGUNA BLVD STE 161
ELK GROVE, CA 95758
Sacramento County (916) 877-7778

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 Maria Theresa Wyson's NPI number?

The NPI number for Maria Theresa Wyson is 1861769648. It was assigned to this individual provider in the NPPES registry on November 22, 2011. The provider is also known as Maria Theresa Sideco Liceralde.

Where is Maria Theresa Wyson located?

Maria Theresa Wyson practices at 7811 Laguna Blvd Ste 161, Elk Grove, CA 95758. The listed phone number is (916) 877-7778.

What is Maria Theresa Wyson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Maria Theresa Wyson enrolled in Medicare?

Yes. Maria Theresa Wyson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Maria Theresa Wyson was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.