Individual provider Active NPI

Bridget Wilson, RN, FNP

  • Nurse Practitioner
  • Cortland, NY
National Provider Identifier
1053841577
Registry record updated Jul 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
341993 Issued in NY
Practice address
134 Homer Ave
Cortland, NY 13045-1206
Phone
(607) 756-3740
NPI assigned
Jun 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
Nurse Practitioner 363L00000X 341993 NY Primary

Addresses

Primary practice location

134 Homer Ave
Cortland, NY 13045-1206

Mailing address

PO Box 4224
Ithaca, NY 14852-4224
Phone (607) 662-4056

Other names 1

  • Ms. Bridgett Wilson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 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

Enrollment IDStateProvider typePAC IDDetails
I20170905002396 NY Practitioner - Nurse Practitioner 7810260304 Reassigns benefits to 4 organizations
I20220811003676 NC Practitioner - Nurse Practitioner 7810260304 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.85 of 100Reported as group
Quality
79.23
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
341993NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Port Emergency Medical Services, P.C. CurrentSince Oct 19, 2022 Accepting new patients
Emergency Medicine Physicians of Mecklenburg County, PLLC CurrentSince Jun 22, 2022 Accepting new patients
Siena Emergency Medical Services, P.C. CurrentSince Oct 18, 2022 Accepting new patients
Emergency Medicine Physicians of Carteret County, PLLC CurrentSince Mar 1, 2023 Accepting new patients
Emergency Medicine Physicians of Cortland County, PLLC CurrentSince Jul 25, 2017 Accepting new patients
Island Emergency Medical Services, P.C. CurrentSince Dec 1, 2022 Accepting new patients

Locations

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

3500 Arendell St
Morehead City, NC 28557
Phone (252) 499-6000

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

600 Northern Blvd
Albany, NY 12204
Phone (518) 427-3331

134 Homer Ave
Cortland, NY 13045
Phone (607) 756-3500

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

103 Sitterly Rd
Halfmoon, NY 12065
Phone (518) 579-2700

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

200 Harborside Dr
Schenectady, NY 12305
Phone (518) 881-4470

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Interoperability endpoints

  • Direct secure messaging: bwilson161398@direct-guthrie.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499385600000",
    "number": "1053841577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4224",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148524224",
            "telephone_number": "607-662-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 HOMER AVE",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130451206",
            "telephone_number": "607-756-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRIDGET",
        "name_prefix": "Ms.",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2017-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "341993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIDGETT",
            "last_name": "WILSON",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cortland, NY

Sources for this page

Verify at the official NPI Registry.