Active NPI
Michael Wilson, MD
- Emergency Medicine Physician
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD20836
- Practice address
- 75 Francis St
Boston, MA 02115-6110 - Phone
- (617) 732-5640
- NPI assigned
- May 20, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 200001030 | NC | |
| Emergency Medicine Physician | 207P00000X | MD20836 | ME | Primary |
Addresses
Primary practice location
75 Francis St
Boston, MA 02115-6110
Mailing address
75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5640
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1268U | Other | NC | BLUE CROSS |
| 891268U | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
25 Highland Ave
Newburyport, MA 01950-3867
Phone (978) 463-1000
75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD20836 | ME | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brigham and Women'S Hospital | Current | Accepting new patients | |
| Newburyport Emergency Physicians, PLLC | Emergency Medicine | Current | Accepting new patients |
| Emergency Medicine Services of Maine, LLC | Emergency Medicine | Current | Accepting new patients |
| Medlantic Healthcare Group | Emergency Medicine | Past | Accepting new patients |
Locations
75 Francis St
Boston, MA 02115
25 Highland Ave
Newburyport, MA 01950
Phone (978) 258-4734
897 W Main St
Dovr Foxcroft, ME 04426
Phone (207) 564-4464
50 Union St
Ellsworth, ME 04605
Phone (207) 664-5304
447 N Main St
Pittsfield, ME 04967
Phone (207) 487-0981
307 S Evergreen Ave
Woodbury, NJ 08096
Phone (856) 686-4300
Interoperability endpoints
- wilson.michael.bwh@direct.partners.masshiway.net
Organizations & group practices 5
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
- Newburyport, MA
- NPI 1215724364
-
- Internal Medicine Physician
- Boston, MA
- NPI 1033535497
-
- Emergency Medicine Physician
- Ellsworth, ME
- NPI 1578032058
-
- General Acute Care Hospital
- Boston, MA
- NPI 1093885816
-
- Emergency Medicine Physician
- Baltimore, MD
- NPI 1467408450
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Newburyport, MA
- NPI 1992779482
-
- General Acute Care Hospital
- Boston, MA
- NPI 1790717650
-
- General Acute Care Hospital
- Boston, MA
- NPI 1578677811
-
- Psychiatric Hospital Unit
- Boston, MA
- NPI 1033121025
-
- General Acute Care Hospital
- Boston, MA
- NPI 1851333686
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719964800000",
"number": "1073567319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 FRANCIS ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021156110",
"telephone_number": "617-732-5640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 FRANCIS ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021156110",
"telephone_number": "617-732-5640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-20",
"last_updated": "2024-07-03",
"certification_date": "2024-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NC",
"license": "200001030",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "ME",
"license": "MD20836",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "1268U",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891268U",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.