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SENIOR DOC WISCONSIN SC
NPI 1932954260
Family Medicine in Orange, CA

Active since April 19, 2024
2592 N SANTIAGO BLVD, ORANGE, CA 92867(855) 434-7763 Get Directions Write a Review

NPPES record last updated: October 11, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Oct 11, 2024, Apr 19, 2024 (2 updates tracked since 2024).

About Senior Doc Wisconsin Sc NPPES

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

SENIOR DOC WISCONSIN SC (NPI 1932954260) is a healthcare organization registered as a family medicine in Orange, California and active in the NPI registry since April 2024. The organization lists Angelica Contact, Credentialing, as its authorized official.

NPPES Registry Identity

NPI1932954260
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSENIOR DOC WISCONSIN SC
Location Address2592 N SANTIAGO BLVDOrange, CA 92867-1862
Mailing Address2592 N Santiago BlvdOrange, CA 92867-1862 · (855) 434-7763
Phone(855) 434-7763
Organization SubpartNo
Authorized OfficialAngelica ContactCredentialing · (855) 434-7763
Enumeration DateApril 19, 2024
Last NPPES UpdateOctober 11, 20242 updates tracked since enumeration
NPPES CertifiedOctober 11, 2024
✔ NPI 1932954260 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2592 N SANTIAGO BLVD, Orange, CA 92867
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Senior Doc Wisconsin Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Senior Doc Wisconsin Sc, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Jeffrey Thomas
Internal Medicine
NPI 1932337136
2592 N SANTIAGO BLVD
Orange, CA 92867
(855) 434-7763
✔ PECOS✔ Accepts MedicareSame address
Meredith Bock, MD
Neurology
NPI 1447612940
505 PARNASSUS AVE
San Francisco, CA 94143
(818) 648-6941
✔ PECOS✔ Accepts Medicare375 mi
Peris Rodriguez, PMHNP
Nurse Practitioner
NPI 1861292443
915 HIGHLAND POINTE DR STE 250
Roseville, CA 95678
(650) 695-3354
✔ PECOS392 mi
Cassie Dundon
Nurse Practitioner
NPI 1831685395
4525 N 133RD ST
Brookfield, WI 53005
(414) 828-8866
✔ PECOS1,724 mi
Rachelle Virgin, FNP
Nurse Practitioner
NPI 1578341913
2230 INCHCLIFF RD
Columbus, OH 43221
(614) 507-2760
✔ PECOS1,958 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Senior Doc Wisconsin Sc's NPI number?

The NPI number for Senior Doc Wisconsin Sc is 1932954260. It was assigned to this organization in the NPPES registry on April 19, 2024.

Where is Senior Doc Wisconsin Sc located?

Senior Doc Wisconsin Sc is located at 2592 N Santiago Blvd, Orange, CA 92867. The listed phone number is (855) 434-7763.

What is Senior Doc Wisconsin Sc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Senior Doc Wisconsin Sc enrolled in Medicare?

Yes. Senior Doc Wisconsin Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Senior Doc Wisconsin Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 3 Medicare specialties reassign their Medicare billing to Senior Doc Wisconsin Sc. A 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 the clinician's services. The largest specialties are Nurse Practitioner (3), Internal Medicine (1) and Neurology (1). Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Senior Doc Wisconsin Sc was last updated on October 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.