Active NPI
Thomas Charles Wilson, DPM
- Podiatrist
- Melbourne, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- PO3765
- Practice address
- 1515 Dr Martin Luther King Jr Blvd
Melbourne, FL 32901-2946 - Phone
- (321) 723-3500
- Fax
- (321) 723-1945
- NPI assigned
- Jun 26, 2013
- Last updated
- May 12, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | SC006507 | PA | |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | PO3765 | FL | |
| Podiatrist | 213E00000X | PO3765 | FL | Primary |
Addresses
Primary practice location
1515 Dr Martin Luther King Jr Blvd
Melbourne, FL 32901-2946
Mailing address
1515 Dr Martin Luther King Jr Blvd
Melbourne, FL 32901-2946
Phone (321) 723-3500
Other practice location 1
1310 W Eau Gallie Blvd Ste E
Melbourne, FL 32935-5300
Phone (321) 255-3338
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Barry University School of Podiatric Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1310 W Eau Gallie Blvd
Melbourne, FL 32935-5300
Phone (321) 255-3338
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.5 of 100
- Quality
- 95
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 110 |
| Removal of skin lesions | 109 |
| Removal of nail tissue | 54 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC006507 | PA | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Melbourne Podiatry Associates, P.a. | Podiatrist | Current | Accepting new patients |
| Briant G. Moyles D.P.M., P.a. | Podiatrist | Current | Accepting new patients |
Locations
1310 W Eau Gallie Blvd
Melbourne, FL 32935
Phone (321) 254-3630
1310 W Eau Gallie Blvd
Ste E
Melbourne, FL 32935
Phone (321) 255-3338
1515 Dr Martin Luther King Jr Blvd
Melbourne, FL 32901
Phone (321) 723-3500
211 E New Haven Ave
Melbourne, FL 32901
Phone (321) 500-4263
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DIHJAA/Endpoint/DIHJAA
- twilson71528@epicdirect.hf.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Melbourne Podiatry Associates
- Podiatrist
- Melbourne, FL
- NPI 1174506877
-
dba Melbourne Podiatry Associates
- Podiatrist
- Melbourne, FL
- NPI 1194998286
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba First Flight
- Air Ambulance
- Melbourne, FL
- NPI 1235312281
Hospital
-
- General Acute Care Hospital
- Melbourne, FL
- NPI 1295702728
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683849600000",
"number": "1184064834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 DR MARTIN LUTHER KING JR BLVD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329012946",
"telephone_number": "321-723-3500",
"fax_number": "321-723-1945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 DR MARTIN LUTHER KING JR BLVD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329012946",
"telephone_number": "321-723-3500",
"fax_number": "321-723-1945"
}
],
"practiceLocations": [
{
"address_1": "1310 W Eau Gallie Blvd Ste E",
"address_purpose": "LOCATION",
"city": "Melbourne",
"state": "FL",
"postal_code": "329355300",
"country_code": "US",
"telephone_number": "321-255-3338",
"fax_number": "321-253-9643",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "THOMAS",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-26",
"last_updated": "2023-05-12",
"certification_date": "2023-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "PA",
"license": "SC006507",
"primary": false
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "FL",
"license": "PO3765",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "FL",
"license": "PO3765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.