Mary Wilson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00391000 Issued in NJ

Practice address

713 Bethlehem Pike
Montgomeryville, PA 18936-9602

Phone

(856) 767-0077

Fax

(856) 767-6102

NPI assigned

Jan 20, 2016

Last updated

Jan 22, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in PA, DE2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Patient First Pennsylvania Medical Group PLLCGroup PAC ID 5193900280, 132 clinicians

Newark Emergency CenterGroup PAC ID 9931620291, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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

• Newark Emergency Center

  • Emergency Medicine Physician
  • Newark, DE
  • NPI 1700864576
  Medicare reassignment Care Compare group
• Patient First Pennsylvania Medical Group PLLC

  • Urgent Care Clinic/Center
  • Glen Allen, VA
  • NPI 1194039560

  PA

  Medicare reassignment Care Compare group
• Patient First Pennsylvania Medical Group PLLC

  • Family Medicine Physician
  • Fairless Hills, PA
  • NPI 1144870387
  NPD
• Patient First Pennsylvania Medical Group PLLC

  • Family Medicine Physician
  • Montgomeryville, PA
  • NPI 1568712677
  NPD
• Berlin Medical Associates, P.a.

  • Family Medicine Physician
  • Berlin, NJ
  • NPI 1174570832
  NPD (past)

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1033576228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 BETHLEHEM PIKE",
            "city": "MONTGOMERYVILLE",
            "state": "PA",
            "postal_code": "189369602",
            "telephone_number": "856-767-0077",
            "fax_number": "856-767-6102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "606 Cross Keys Rd",
            "address_purpose": "LOCATION",
            "city": "Sicklerville",
            "state": "NJ",
            "postal_code": "080819513",
            "country_code": "US",
            "telephone_number": "856-237-1016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00391000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valley Prosthetics & Orthotics, Inc
• Wachtel Podiatry Group, LLC
• Jeffrey I Wachtel, DPM
• Kaitlin T. Wenger, LCSW
• Ann E Werntz
• Inwook Yeo
• Brendan James Young, LCSW

• Physician Assistant in Montgomeryville, PA
• Providers in Montgomeryville, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.