Robert Wilson, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD052629L Issued in PA

Practice address

1330 W 26TH St
Erie, PA 16508-1402

Phone

(814) 459-9300

Fax

(814) 454-7780

NPI assigned

Jan 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, CA2 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

Specialty

Psychiatry

Education

University of Rochester School of Medicine and Dentistry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peach Tree HealthcareGroup PAC ID 7416978440, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: robert.wilson.p1@direct.peachtreehealth.nextgenshare.com

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.

• Peach Tree Healthcare

  • Federally Qualified Health Center (FQHC)
  • Marysville, CA
  • NPI 1003863622

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Family Services of NW PA

  • Child & Adolescent Psychiatry Physician
  • Erie, PA
  • NPI 1265482863
  Medicare reassignment NPD
• Peach Tree Healthcare

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1245043413
  NPD
• Peach Tree Healthcare

  • Federally Qualified Health Center (FQHC)
  • Chico, CA
  • NPI 1922598226
  NPD

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1336110279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081402",
            "telephone_number": "814-456-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081402",
            "telephone_number": "814-459-9300",
            "fax_number": "814-454-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD052629L",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G179480",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "G179480",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD052629L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SafeHarbor@upmcdirect.com",
            "affiliation": "N",
            "endpointDescription": "secure UPMC direct address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1330 W 26th St",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165081402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rosemary J C Williamson, PT, DPT, HFS
• Allie Willis
• Alexandra K Wilson, PA-C
• Heather Rose Wilson, MA CCCSLP
• Jenny R Wilson, CRNA
• Hailey Wilwohl
• Kayla Wilwohl
• Amanda Marie Wincik, DO
• Alexa Paige Windsor
• Stacy Lynn Wing, PT

• Child & Adolescent Psychiatry Physician in Erie, PA
• Providers in Erie, PA by specialty
• Child & Adolescent Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.