Individual provider Active NPI

James R Wilson, M.D.

  • Diagnostic Radiology Physician
  • Orlando, FL
National Provider Identifier
1043218662
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME76977 Issued in FL
Practice address
601 E Rollins St
Orlando, FL 32803-1248
Phone
(407) 303-1944
Fax
(407) 303-1746
NPI assigned
Jul 8, 2005
Last updated
Dec 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X ME76977 FL
Diagnostic Radiology Physician 2085R0202X 35441 KY
Diagnostic Radiology Physician 2085R0202X ME76977 FL Primary

Addresses

Primary practice location

601 E Rollins St
Orlando, FL 32803-1248

Mailing address

PO Box 150505
Altamonte Springs, FL 32715-0505
Phone (407) 767-0433

Other identifiers 3

IdentifierTypeStateIssuer
300131477OtherFLRR MEDICARE
44559OtherFLBCBS OF FLORIDA
255154300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081230000269 FL Practitioner - Diagnostic Radiology 8426110438 Reassigns benefits to 2 organizations
I20230105000663 KY Practitioner - Diagnostic Radiology 8426110438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Texas Tech University Health Science Center School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0042383200, 329 clinicians

Practice addresses (Care Compare)

1055 Saxon Blvd
Orange City, FL 32763-8468
Phone (386) 917-5000

200 N Lakemont Ave
Winter Park, FL 32792-3273
Phone (407) 646-7000

2000 Fowler Grove Blvd
Winter Garden, FL 34787-5050
Phone (407) 200-2355

210 Marie Langdon Dr
Manchester, KY 40962-6388
Phone (606) 598-5104

2450 N Orange Blossom TRL
Kissimmee, FL 34744-2316
Phone (407) 846-4343

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone (386) 231-6000

400 Celebration PL
Celebration, FL 34747-4970
Phone (407) 764-4000

60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980
Phone (386) 586-2000

601 E Altamonte Dr
Altamonte SPG, FL 32701-4802
Phone (407) 830-4321

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-5600

701 W Plymouth Ave
Deland, FL 32720-3236
Phone (386) 943-4522

7727 Lake Underhill Rd
Orlando, FL 32822-8224
Phone (407) 303-8110

900 Winderley PL
Suite 1100
Maitland, FL 32751-7229
Phone (407) 200-2355

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME76977FLMDNuclear Radiology Physician
ME73790FLMDDiagnostic Radiology Physician
35441KYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Radiology Imaging at Lake Mary, LLC Nuclear Radiology CurrentSince May 4, 2013 Accepting new patients
Team Radiology Physicians, PA Diagnostic Radiology Past Accepting new patients

Locations

235 E Princeton St
Ste 100
Orlando, FL 32804
Phone (407) 303-1414

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jwilson56739@adventhealth.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1043218662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150505",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327150505",
            "telephone_number": "407-767-0433",
            "fax_number": "407-767-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-303-1944",
            "fax_number": "407-303-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JAMES",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "FL",
            "license": "ME76977",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "35441",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME76977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "300131477",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "44559",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255154300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.