Active NPI
Peter B Wilton, MD
- Surgery Physician
- Maplewood, MN
National Provider Identifier
1124093661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 29713
- Practice address
- 1655 Beam Ave Ste 302
Maplewood, MN 55109 - Phone
- (651) 227-6351
- NPI assigned
- Feb 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 29713 | MN | Primary |
Addresses
Primary practice location
1655 Beam Ave Ste 302
Maplewood, MN 55109
Mailing address
310 Smith Ave N
Saint Paul, MN 55102-2383
Phone (952) 843-4333
Other practice location 1
310 Smith Ave N
Saint Paul, MN 55102-2393
Phone (952) 843-4333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 086278900 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healtheast Medical Research Institute | Current | Accepting new patients |
Locations
1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002
1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273
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.
-
- Clinic/Center
- Vadnais Heights, MN
- NPI 1639125503
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529366400000",
"number": "1124093661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 SMITH AVE N",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551022383",
"telephone_number": "952-843-4333",
"fax_number": "952-843-4301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1655 BEAM AVE STE 302",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "55109",
"telephone_number": "651-227-6351"
}
],
"practiceLocations": [
{
"address_1": "310 Smith Ave N",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551022393",
"country_code": "US",
"telephone_number": "952-843-4333",
"fax_number": "952-843-4301",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILTON",
"first_name": "PETER",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-20",
"last_updated": "2018-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MN",
"license": "29713",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "086278900",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maplewood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.