Physician Compare National (NPI:1942321138)

HEALTHCARE PROVIDER: CRAIG A WILKES DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1942321138
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3274555602
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20051228000422
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WILKES
	Individual professional last name
Provider First Name	CRAIG
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DPM
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	9692 SWAN LAKE DR
	Group Practice or individual's line 1 address
City	GRANITE BAY
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	957466605
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9164325200
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050309
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SUTTER ROSEVILLE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y