Active NPI
Emilee Marie Wilson, PA
- Physician Assistant
- Dedham, MA
National Provider Identifier
1073277232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA8677
- Practice address
- 173 Jefferson St
Dedham, MA 02026-5028 - Phone
- (617) 894-7337
- NPI assigned
- Oct 25, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | PA8677 | MA | Primary |
Addresses
Primary practice location
173 Jefferson St
Dedham, MA 02026-5028
Mailing address
173 Jefferson St
Dedham, MA 02026-5028
Other practice location 1
115 Lincoln St
Framingham, MA 01702-6358
Phone (508) 383-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110190297A | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Worcester, MA
- NPI 1730885252
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697155200000",
"number": "1073277232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "173 JEFFERSON ST",
"city": "DEDHAM",
"state": "MA",
"postal_code": "020265028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "173 JEFFERSON ST",
"city": "DEDHAM",
"state": "MA",
"postal_code": "020265028",
"telephone_number": "617-894-7337"
}
],
"practiceLocations": [
{
"address_1": "115 Lincoln St",
"address_purpose": "LOCATION",
"city": "Framingham",
"state": "MA",
"postal_code": "017026358",
"country_code": "US",
"telephone_number": "508-383-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "EMILEE",
"middle_name": "MARIE",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-25",
"last_updated": "2023-10-13",
"certification_date": "2023-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA8677",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110190297A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dedham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.