Individual provider Active NPI

Sean Wilson, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1275650640
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
230067 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 732-5845
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 230067 MA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

1443 Beacon St
Apt 6C
Brookline, MA 02446-4707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140902000735 NJ Practitioner - Interventional CardiologyPractitioner - Pediatric Medicine 3577628569 Reassigns benefits to 1 organization
I20200511000839 NY Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3577628569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
269887NYMDLicensed Practical Nurse
230067MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC Internal Medicine CurrentSince Sep 22, 2021 Accepting new patients
Valley Physician Services PC Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
North Shore University Hospital Past Accepting new patients

Locations

1 Valley Health Plz
Paramus, NJ 07652
Phone (201) 634-5353

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Fl 1
Manhasset, NY 11030
Phone (516) 562-2252

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: seanwilson@nslijmedgr.allscriptsdirect.net

Organizations & group practices 4

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 3

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275650640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 BEACON ST",
            "address_2": "APT 6C",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-5845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "230067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.