Mary A Wilson, CRNA - Medicare Nurse Anesthetist, Certified Registered in Rancho Cucamonga, CA

  1. Home
  2. Nurse Anesthetist - CR
  3. CA
  4. Rancho Cucamonga
Mary A Wilson, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Rancho Cucamonga, California. Her current practice location is 10841 White Oak Ave, Rancho Cucamonga, California. You can reach out to her office (for appointments etc.) via phone at (909) 581-6400.

Mary A Wilson is licensed to practice in California (license number NA 2575) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1770599615.

Contact Information

Mary A Wilson, CRNA
10841 White Oak Ave,
Rancho Cucamonga, CA 91730-3817
(909) 581-6400
(909) 581-6418

Map and Direction




Provider's Profile

Full NameMary A Wilson
GenderFemale
SpecialityNurse Anesthetist, Certified Registered
Location10841 White Oak Ave, Rancho Cucamonga, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1770599615
  • Provider Enumeration Date: 07/31/2006
  • Last Update Date: 12/02/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 2769376268
  • Enrollment ID: I20040213000156

Medical Identifiers

Medical identifiers for Mary A Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1770599615NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered NA 2575 (California)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mary A Wilson allows following entities to bill medicare on her behalf.
Entity NameSouthern California Permanente Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1316979834
PECOS PAC ID: 6002729175
Enrollment ID: O20040126000823
Entity NameDalia Gourgy Md Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1316382526
PECOS PAC ID: 8224277140
Enrollment ID: O20130625000293

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mary A Wilson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mary A Wilson, CRNA
210 N Tustin Ave,
Santa Ana, CA 92705-3807

Ph: (714) 347-1010		Mary A Wilson, CRNA
10841 White Oak Ave,
Rancho Cucamonga, CA 91730-3817

Ph: (909) 581-6400

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Rancho Cucamonga, CA

Kevin Jon Millet, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 9674 Archibald Ave Ste 125, Rancho Cucamonga, CA 91730
Phone: 909-296-8930    Fax: 909-296-8935
Mrs. Cathy Tang Sayat,
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 11660 Church St, Unit 123, Rancho Cucamonga, CA 91730
Phone: 909-524-6808    
Mr. James C Estrada, CRNA
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 8641 Mandarin Ave, Rancho Cucamonga, CA 91701
Phone: 909-987-7196    Fax: 909-987-7196
Andrea Marie Dowdy,
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 10841 White Oak Ave, Rancho Cucamonga, CA 91730
Phone: 909-581-6400    Fax: 909-581-6418

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.