Brandon Wilson, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9107780 Issued in FL

Practice address

10475 Centurion Pkwy N Ste 220
Jacksonville, FL 32256-5004

Phone

(904) 634-0640

Fax

(904) 634-0203

NPI assigned

Jan 17, 2014

Last updated

Jul 28, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Southeast Orthopedic Specialists LLCGroup PAC ID 1456246974, 144 clinicians

Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent's Southside Hospital, Jacksonville, FL, CCN 100307
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

Merit-based Incentive Payment System (MIPS)

Final score

90.75 of 100Reported as group

Quality

88.19

Promoting interoperability

100

Improvement activities

40

Cost

80.96

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brandon.wilson.1@22724.direct.athenahealth.com

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.

• Southeast Orthopedic Specialists, LLC

  • Orthopaedic Surgery Physician
  • Jacksonville, FL
  • NPI 1629025820
  Medicare reassignment Care Compare group NPD
• Lake Area Physical Therapy Inc

  dba Lake Area Physical Therapy & Aquatics

  • Physical Therapist
  • Melrose, FL
  • NPI 1376682518
  Care Compare group
• Southeast Orthopedic Specialists, LLC

  • Durable Medical Equipment & Medical Supplies
  • Saint Johns, FL
  • NPI 1538952379
  NPD
• Sunshine Surgical Assist Inc

  • Specialist
  • Clearwater, FL
  • NPI 1568090975
  NPD (past)
• Brazos Sa Services

  • Specialist
  • Houston, TX
  • NPI 1033382668
  NPD (past)
• Center for Orthopedic Research and Education, LLC

  dba The CORE Institute

  • Orthopaedic Surgery Physician
  • Phoenix, AZ
  • NPI 1427095801

  Physician Assistant

  NPD (past)

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

• Genesis Rehabilitation Hospital, Inc.

  dba Brooks Rehabilitation Hospital Bartram Campus

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1376114413

  Inpatient rehabilitation facility

  Care Compare affiliation
• Genesis Rehabilitation Hospital, Inc.

  dba Brooks Rehabilitation

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1912947748

  Inpatient rehabilitation facility

  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  dba Baptist Medical Center

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation
• St Lukes - St Vincents Healthcare

  dba Ascension St. Vincent's Southside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747
  Care Compare affiliation

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1285056770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 SOUTHPOINT PKWY STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168203",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10475 CENTURION PKWY N STE 220",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565004",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29277 US Highway 19 N",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337612102",
            "country_code": "US",
            "telephone_number": "713-779-9800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4268 Oldfield Crossing Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322238800",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1690 US Highway 1 S Ste F",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320846024",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15255 Max Legget Pkwy Ste 5300",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322187274",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "216 Southpark Cir E Ste 216",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865135",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2627 Riverside Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044717",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Shircliff Way Ste 605",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044762",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3055 County Road 210 W Ste 110",
            "address_purpose": "LOCATION",
            "city": "St Johns",
            "state": "FL",
            "postal_code": "322597001",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4565 US Highway 17 Ste 17",
            "address_purpose": "LOCATION",
            "city": "Fleming Island",
            "state": "FL",
            "postal_code": "320034842",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "232 Ponte Vedra Park Dr",
            "address_purpose": "LOCATION",
            "city": "Ponte Vedra Beach",
            "state": "FL",
            "postal_code": "320826600",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRANDON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-17",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "FL",
            "license": "PA9107780",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107780",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9107780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122700900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Wilson
• Andrea Nicole Wilson, CNP
• Andria Wilson, PT, DPT
• Andy Wilson, ARNP
• Annette L Wilson, PA-C
• Brea Wilson
• Brook Eden Wilson, APRN-C
• Brooke Wilson
• Chelsea Wilson, BACHELOR LEVEL
• Claire Elizabeth Wilson, MD

• Surgical Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.

Verify at the official NPI Registry.