Theresa Wilson, in San Clemente, CA - Medicare Nurse Practitioner

Theresa Wilson, is a medicare enrolled "Nurse Practitioner - Family" in San Clemente, California. Her current practice location is 724 S El Camino Real, San Clemente, California. You can reach out to her office (for appointments etc.) via phone at (949) 493-6113.

Theresa Wilson is licensed to practice in California (license number 8242) 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 1760631592.

Contact Information

	Theresa Wilson,
	724 S El Camino Real, San Clemente, CA 92672-4250
	(949) 493-6113
	(949) 493-5851

Map and Direction

Provider's Profile

Full Name	Theresa Wilson
Gender	Female
Speciality	Nurse Practitioner - Family
Location	724 S El Camino Real, San Clemente, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1760631592
Provider Enumeration Date: 09/17/2008
Last Update Date: 09/22/2025

Medicare PECOS Information:

PECOS PAC ID: 2769534536
Enrollment ID: I20090709000400

Medical Identifiers

Medical identifiers for Theresa Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1760631592	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	8242 (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. Theresa Wilson allows following entities to bill medicare on her behalf.

Entity Name	Centers For Family Medicine Gp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1467598243 PECOS PAC ID: 9931143799 Enrollment ID: O20050614000191

Entity Name	Minuteclinic Diagnostic Medical Group Of Orange County Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1104013879 PECOS PAC ID: 5991868929 Enrollment ID: O20090116000214

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. Theresa 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 Address	Practice Location Address
Theresa Wilson, Po Box 35380, Las Vegas, NV 89133-5380 Ph: () -	Theresa Wilson, 724 S El Camino Real, San Clemente, CA 92672-4250 Ph: (949) 493-6113

Reviews and Comments

Nurse Practitioner Nurses in San Clemente, CA

Katarzyna Anna Hudson, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 638 Camino De Los Mares, San Clemente, CA 92673 Phone: 714-348-6790
Mrs. Kellie Christine Atkins, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 111 Via Plumosa, San Clemente, CA 92673 Phone: 949-291-9617
Dr. Bimisa Chata Augustin, DNP, MSN, APRN,FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2719 S El Camino Real, San Clemente, CA 92672 Phone: 737-377-1600 Fax: 949-569-1295
Mrs. Victoria Lynn Whalen, APRN, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 638 Camino De Los Mares, San Clemente, CA 92673 Phone: 866-389-2727
Sonia Gordon Luckey, DNP, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 638 Camino De Los Mares, San Clemente, CA 92673 Phone: 949-494-8426
Linda Marie Long, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 187 Avenida La Pata, San Clemente, CA 92673 Phone: 949-528-4758 Fax: 949-288-0432
Cinthia Irene Walker, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1401 N El Camino Real Ste 100, San Clemente, CA 92672 Phone: 858-522-0145

Theresa Wilson, - Medicare Nurse Practitioner in San Clemente, CA