DR. ELISABETH REGINA WIDMAN (MD) – Family Medicine Physician, NPI 1831173855

DR. ELISABETH REGINA WIDMAN (MD) is a healthcare provider. based in San rafael, California. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. G46518 (CA). The NPI Number for DR. ELISABETH REGINA WIDMAN (MD) is 1831173855

Main info

Female
Sole Proprietor
51 Years Of Experience
Name
DR. ELISABETH REGINA WIDMAN (MD)
NPI
1831173855
Phone
(415) 256-1980
Address
706 D ST
Enumeration Date
2 December 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
UNIVERSITY OF MIAMI, LM MILLER SCHOOL OF MEDICINE
Secondary Phone
4154761000
Graduation Year
1975 (51 years ago)
PAC ID
4486698412
Group Practice PAC ID
6305160300
Professional Enrollment ID
I20050610000533
Address ID
CA941432204SA505XXAVEX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

13,194 FAMILY PRACTICE in CA

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Provider Addresses for DR. ELISABETH REGINA WIDMAN (MD)

  • 706, D Street, San Rafael, Marin County, California, 94901, United States

    SAN RAFAEL, CA 949013757

    Phone: (415) 256-1980

    Fax: (415) 256-1981

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-06-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050610000533IFamily PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99215Established patient office or other outpatient visit, 40-54 minutes226184$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit154154$0
99421Online digital evaluation and management service for an established patient for up to 7 days, total time 5-10 minutes5233$0
99214Established patient office or other outpatient visit, 30-39 minutes3534$0
99213Established patient office or other outpatient visit, 20-29 minutes2121$0
View full utilization report →

Insurance plans in this area (ZIP 94901)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305160300View full group profile
NameSpecialtyState
General SurgeryCA
Cardiac Electrophysiology, Internal Medicine, Nuclear Medicine, Cardiovascular Disease (Cardiology)CA
Surgical OncologyCA
Orthopedic SurgeryCA
Orthopedic Surgery, Sports MedicineCA
-CA
P S Y C H I A T R YCA
-CA
O B S T E T R I C S/ G Y N E C O L O G YCA
-CA

Reviews

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Frequently asked questions

What federal number belongs to DR. ELISABETH REGINA WIDMAN (MD)?
The federal identifier for DR. ELISABETH REGINA WIDMAN (MD) is NPI 1831173855.
Does this profile mean DR. ELISABETH REGINA WIDMAN (MD) is currently active?
Yes — DR. ELISABETH REGINA WIDMAN (MD) appears active in the national provider directory.
Does DR. ELISABETH REGINA WIDMAN (MD) list a primary specialty?
If you are matching referrals, note Family Medicine Physician for DR. ELISABETH REGINA WIDMAN (MD). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. ELISABETH REGINA WIDMAN (MD)?
The page summarizes San Rafael, California for DR. ELISABETH REGINA WIDMAN (MD); expand the address list for detail.
What if San Rafael, California seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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