DR. MATTHEW DWAIN WILSON M.D.
NPI 1942567672
Pediatrics in Loma Linda, CA

Active since April 19, 2012PECOS Enrolled
11175 CAMPUS ST, LOMA LINDA, CA 92350(909) 558-8142(909) 558-5981 Get Directions Write a Review

NPPES record last updated: June 8, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Matthew Dwain Wilson M.d. NPPES

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

DR. MATTHEW DWAIN WILSON M.D. (NPI 1942567672) is an individual pediatrics provider in Loma Linda, California, licensed in California (C209024) and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1942567672
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. MATTHEW DWAIN WILSONCredential: M.D.
Location Address11175 CAMPUS STLoma Linda, CA 92350-1700
Mailing Address11175 Campus StLoma Linda, CA 92350-1700 · (909) 558-8142 · Fax (909) 558-5981
Fax(909) 558-5981
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateApril 19, 2012
Last NPPES UpdateJune 8, 2026
NPPES CertifiedJune 8, 2026
✔ NPI 1942567672 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · C209024
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
11175 CAMPUS ST, Loma Linda, CA 92350

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Matthew Dwain Wilson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8628371184
PECOS Enrollment IDI20260608003079
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Matthew Wilson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Neurology
11234 ANDERSON ST, STE. A233
Loma Linda, CA 92354
  • Reassigned Medicare billing, California enrollment
  • 2,584 clinicians in this Medicare group
Urology
19333 BEAR VALLEY RD, SUITE 106
Apple Valley, CA 92308
  • Reassigned Medicare billing, California enrollment
  • 1,699 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 92350 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
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 20

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

Surgery (Surgical Critical Care)
11175 CAMPUS ST, RM 21008
LOMA LINDA, CA 92350
Pediatrics (Pediatric Nephrology)
11175 CAMPUS ST
LOMA LINDA, CA 92350
Student in an Organized Health Care Education/Training Program
11175 CAMPUS ST
LOMA LINDA, CA 92350
Surgery (Surgical Oncology)
11175 CAMPUS ST
LOMA LINDA, CA 92350
Physician Assistant
11175 CAMPUS ST
LOMA LINDA, CA 92350
Pediatrics
11175 CAMPUS ST, SUITE 11120
LOMA LINDA, CA 92350
Physician Assistant
11175 CAMPUS ST
LOMA LINDA, CA 92350
Clinic/Center (Dental)
11175 CAMPUS ST
LOMA LINDA, CA 92350

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 Matthew Wilson's NPI number?

The NPI number for Matthew Wilson is 1942567672. It was assigned to this individual provider in the NPPES registry on April 19, 2012.

Where is Matthew Wilson located?

Matthew Wilson practices at 11175 Campus St, Loma Linda, CA 92350. The listed phone number is (909) 558-8142.

What is Matthew Wilson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Matthew Wilson enrolled in Medicare?

Yes. Matthew Wilson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Matthew Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Matthew Wilson reassigns Medicare benefits to 2 organizations: Faculty Physicians And Surgeons Of Llusm (Loma Linda, CA) and Providence Medical Foundation (Apple Valley, 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 Matthew 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 Matthew Wilson was last updated on June 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.