Organization Active NPI

Anthony J Wilson MD PLLC

Doing business as AW Plastic Surgery

  • Plastic and Reconstructive Surgery Physician
  • Portsmouth, NH
National Provider Identifier
1114410461
Registry record updated Jun 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
ANTHONY J WILSON MD PLLC
Doing business as
AW Plastic Surgery
Practice address
500 Market St Unit 1a
Portsmouth, NH 03801-3456
Phone
(603) 294-4526
Fax
(603) 590-2662
NPI assigned
Jun 12, 2018
Last updated
Jun 12, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2018

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

Authorized official

Name
Anthony Wilson, MDNPI 1659699908
Title
Owner
Phone
(603) 294-4526

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X NU Primary

Addresses

Primary practice location

500 Market St Unit 1a
Portsmouth, NH 03801-3456

Mailing address

520 South St
Portsmouth, NH 03801-5230
Phone (603) 294-4526

Other names 1

  • AW Plastic Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180719002150 NH Part B Supplier - Clinic/Group Practice 1850648007 Receives reassigned benefits from 3 practitioners
Practice locations: Portsmouth, NH; Stratham, NH

National Provider Directory

National Provider Directory

Locations

500 Market St
Unit 1A
Portsmouth, NH 03801
Phone (603) 294-4526

500 Market St
Unit 1B
Portsmouth, NH 03801
Phone (603) 294-4526

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528761600000",
    "number": "1114410461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 SOUTH ST",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038015230",
            "telephone_number": "603-294-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARKET ST UNIT 1A",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038013456",
            "telephone_number": "603-294-4526",
            "fax_number": "603-590-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY J WILSON MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-12",
        "last_updated": "2018-06-12",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "603-294-4526",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AW Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portsmouth, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.