Individual provider Active NPI

Peter Clifford Wilmot, DO

  • Pediatric Gastroenterology Physician
  • Morristown, NJ
National Provider Identifier
1093766875
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
MB072525 Issued in NJ
Practice address
100 Madison Avenue
Morristown, NJ 07960
Phone
(973) 971-5676
Fax
(973) 290-7365
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X MB072525 NJ Primary
Pediatric Gastroenterology Physician 2080P0206X C2-0007817 DE

Addresses

Primary practice location

100 Madison Avenue
Morristown, NJ 07960

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (973) 359-0534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20061109000240 NJ Practitioner - Pediatric MedicinePractitioner - Gastroenterology 2163429945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Gastroenterology
Education
Lake Erie College of Osteopathic Medicine, Erie, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

55 Madison Ave
FL 2
Morristown, NJ 07960-7337
Phone (973) 971-5996

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C2-0007817DEMDPediatric Gastroenterology Physician
MB072525NJMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group Pediatric Gastroenterology CurrentSince Sep 18, 2010 Accepting new patients
Specialty Care of Practice Associates,PA Past Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 200
Morristown, NJ 07960
Phone (973) 971-7130

11 Overlook Rd
Summit, NJ 07901
Phone (908) 273-1493

11 Overlook Rd
Ste 230
Summit, NJ 07901
Phone (973) 971-4142

Organizations & group practices 2

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1093766875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "973-359-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MADISON AVENUE",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "07960",
            "telephone_number": "973-971-5676",
            "fax_number": "973-290-7365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMOT",
        "first_name": "PETER",
        "middle_name": "CLIFFORD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NJ",
            "license": "MB072525",
            "primary": true
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "DE",
            "license": "C2-0007817",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

Verify at the official NPI Registry.