Brandon Ross Wilson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60319271 Issued in WA

Practice address

3726 Broadway Ste 201
Everett, WA 98201-3788

Phone

(425) 317-9119

Fax

(425) 317-9118

NPI assigned

Oct 12, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western Washington Medical Group Inc PSGroup PAC ID 7517870314, 111 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brandon.wilson@direct.vmmc.org
• Direct secure messaging: bwilson727208@direct.multicare.org

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.

• Western Washington Medical Group, Inc PS

  • Psychiatry Physician
  • Everett, WA
  • NPI 1396413803
  Medicare reassignment Care Compare group
• King County Public Hospital District No 2

  • Neuromusculoskeletal Medicine & OMM Physician
  • Kirkland, WA
  • NPI 1801986070
  Medicare reassignment
• King County Public Hospital District No 2

  • Internal Medicine Physician
  • Kirkland, WA
  • NPI 1467542639
  NPD
• King County Public Hospital District No. 2

  • Physical Therapist
  • Kirkland, WA
  • NPI 1356920946
  NPD
• Western Washington Medical Group, Inc PS

  • Nephrology Physician
  • Everett, WA
  • NPI 1417175811
  NPD
• Western Washington Medical Group, Inc PS

  • Infectious Disease Physician
  • Everett, WA
  • NPI 1427816305
  NPD
• Western Washington Medical Group, Inc PS

  • Gastroenterology Physician
  • Everett, WA
  • NPI 1023065919
  NPD (past)

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

• Providence Health & Services-Wa

  • Hospitalist Physician
  • Everett, WA
  • NPI 1649615220
  Care Compare affiliation
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  Care Compare affiliation

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1336491588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3726 BROADWAY STE 201",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013788",
            "telephone_number": "425-317-9119",
            "fax_number": "425-317-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3726 BROADWAY STE 201",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013788",
            "telephone_number": "425-317-9119",
            "fax_number": "425-317-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRANDON",
        "middle_name": "ROSS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-12",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2012-0050",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60319271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margo Rain Willis
• Sue Willis
• Willow Family Medicine PLLC
• Nina T Willow, M.D.
• Lyndal Deanne Wilson-Bishop, PA
• Brittany Wilson
• Carlee Ann Wilson
• Christina Wilson, MA, MHP
• Constance Marie Wilson, CG
• Jennifer Anne Wilson, D.C.

• Physician Assistant in Everett, WA
• Providers in Everett, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.