NPIMap

Individual provider Active NPI

Keren T Wilson, D.O.

  • Family Medicine Physician
  • Tewksbury, MA
National Provider Identifier
1154570372
Registry record updated Oct 21, 2009
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Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
238880 Issued in MA
Practice address
2345 Main Street
Tewksbury, MA 01876
Phone
(978) 658-9931
Fax
(978) 694-0991
NPI assigned
Sep 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125050546 IL
Family Medicine Physician 207Q00000X 238880 MA Primary

Addresses

Primary practice location

2345 Main Street
Tewksbury, MA 01876

Mailing address

P.O. Box 760
Winchester, MA 01890
Phone (781) 756-7273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090424000411 MA Practitioner - Family Practice 9436207750 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beth Israel Lahey Health Primary Care, IncGroup PAC ID 7719291434, 351 clinicians
Beth Israel Lahey Health Specialty Care, Inc.Group PAC ID 2365405024, 264 clinicians

Practice addresses (Care Compare)

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8400

Hospital & facility affiliations

  • Beth Israel Lahey Health at Home Home health agency, Beverly, MA, CCN 227495
  • Winchester Hospital Hospital, Winchester, MA, CCN 220105
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Northeast Rehabilitation Hospital Inpatient rehabilitation facility, Salem, NH, CCN 303026

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125050546ILMDFamily Medicine Physician
238880MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Suburban Surgical Associates PC CurrentSince Jan 2, 2013 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Dec 1, 2024 Accepting new patients
Winchester Physician Associates, Inc Family Medicine CurrentSince Apr 1, 2016 Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Lahey Clinic, Inc Current Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Winchester Physician Associates Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

203 Main St
North Reading, MA 01864
Phone (978) 664-1990

1 Essex Dr
Peabody, MA 01960
Phone (978) 538-4000

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

3 Woodland Rd
Ste 212
Stoneham, MA 02180
Phone (781) 662-2288

2345 Main St
Tewksbury, MA 01876
Phone (978) 658-9931

200 Unicorn Park Dr
Ste 401
Woburn, MA 01801
Phone (781) 756-6760

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256083200000",
    "number": "1154570372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 760",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "01890",
            "telephone_number": "781-756-7273",
            "fax_number": "781-721-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 MAIN STREET",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "01876",
            "telephone_number": "978-658-9931",
            "fax_number": "978-694-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KEREN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-11",
        "last_updated": "2009-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125050546",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "238880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

Verify at the official NPI Registry.