Beverly N Wilson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C0006301 Issued in MD

Practice address

12038 Ocean Gateway
Unit 1
Ocean City, MD 21842

Phone

(410) 390-3341

Fax

(410) 390-3618

NPI assigned

Dec 13, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tidalhealth Atlantic IncGroup PAC ID 2365437837, 95 clinicians

Tidalhealth Primary Care LLCGroup PAC ID 7911320635, 63 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Homecall Home health agency, Easton, MD, CCN 217066
• Atlantic General Hospital Hospital, Berlin, MD, CCN 210061
• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019

Merit-based Incentive Payment System (MIPS)

Final score

82.2 of 100Reported as group

Quality

70.92

Promoting interoperability

98

Improvement activities

40

Cost

71.41

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: beverlyweaver@agh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tidalhealth Primary Care, LLC

  • Family Medicine Physician
  • Salisbury, MD
  • NPI 1104453208
  Medicare reassignment Care Compare group NPD
• Atlantic General Hospital Corporation

  • Family Medicine Physician
  • Berlin, MD
  • NPI 1871582171
  Medicare reassignment Care Compare group
• Tidalhealth Atlantic, Inc.

  • Community/Retail Pharmacy
  • Berlin, MD
  • NPI 1740963859
  NPD
• Atlantic Immedicare LLC

  • General Practice Physician
  • Ocean City, MD
  • NPI 1518199223
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Homecall, LLC

  • Home Health Agency
  • Easton, MD
  • NPI 1700971843
  Care Compare affiliation Name & address match
• Tidalhealth Atlantic, Inc

  • General Acute Care Hospital
  • Berlin, MD
  • NPI 1053309120
  Care Compare affiliation
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1023552817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12038 OCEAN GATEWAY",
            "address_2": "UNIT 1",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "21842",
            "telephone_number": "410-390-3341",
            "fax_number": "410-390-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12038 OCEAN GATEWAY",
            "address_2": "UNIT 1",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "21842",
            "telephone_number": "410-390-3341",
            "fax_number": "410-390-3618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BEVERLY",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-13",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0006301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "C0006301",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Weiss
• Christina Werrlein, PA-C
• Brian Edward Whitman Sr.
• William T. Greer III M.D. P.C.
• Sean A Williams, D.C.
• Jacob Norman Windsor
• Amanda R Winters, LMT
• Jakiera Wise
• Jennifer Michele Wissler, CAC-AD
• Ronald Marc Wist, PT

• Medical Physician Assistant in Ocean City, MD
• Providers in Ocean City, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.