NPIMap

Individual provider Active NPI

Nathan E Wilson, M.D.

  • Internal Medicine Physician
  • Biddeford, ME
National Provider Identifier
1376500314
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
012099 Issued in ME
Practice address
30 W Cole Rd
Biddeford, ME 04005-9458
Phone
(207) 282-3349
Fax
(207) 282-6099
NPI assigned
Apr 26, 2006
Last updated
Sep 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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 012099 ME Primary

Addresses

Primary practice location

30 W Cole Rd
Biddeford, ME 04005-9458

Mailing address

1 Medical Center Dr
Suite 201
Biddeford, ME 04005-9422
Phone (207) 282-9080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050713000616 ME Practitioner - Internal Medicine 5799711529 Reassigns benefits to 1 organization
I20200219002916 MA Practitioner - Internal Medicine 5799711529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Revere Medical of Massachusetts PCGroup PAC ID 0749715795, 113 clinicians

Practice addresses (Care Compare)

1 Pearl St
Suite 2200
Brockton, MA 02301-2874
Phone (508) 897-6050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012099MEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Medical of Massachusetts, PC Internal Medicine CurrentSince Jan 18, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince Feb 1, 2020 Accepting new patients
Mainehealth CurrentSince Oct 1, 2008 Accepting new patients
Steward Medical Group, Inc CurrentSince Feb 1, 2020 Accepting new patients
Mainehealth CurrentSince Oct 1, 2008 Accepting new patients
West Bridgewater Medical Investors, LLC Past Accepting new patients
Primecare Physician Associates Internal Medicine Past Accepting new patients
Alternative Wellness Services PastSince Dec 7, 2018 Accepting new patients

Locations

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

1 Pearl St
Ste 1000
Brockton, MA 02301
Phone (508) 897-6050

1 Pearl St
Ste 2200
Brockton, MA 02301
Phone (508) 897-6150

1 Pearl St
Ste 2400
Brockton, MA 02301
Phone (508) 897-6050

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

9 Galen St
Watertown, MA 02472
Phone (617) 562-5413

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

30 W Cole Rd
Biddeford, ME 04005
Phone (207) 282-3349

9 Healthcare Dr
Ste 101
Biddeford, ME 04005
Phone (207) 282-4270

9 Healthcare Dr
Ste 201
Biddeford, ME 04005
Phone (207) 282-9080

9 Healthcare Dr
Ste 202
Biddeford, ME 04005
Phone (207) 283-1427

Interoperability endpoints

  • Direct secure messaging: nathan.wilson.1@32866.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hospice of Southern MaineScarborough, ME, CCN 201511 Hospice Corporate Director Jan 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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.

Hospital & facility affiliations 10

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1376500314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "SUITE 201",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059422",
            "telephone_number": "207-282-9080",
            "fax_number": "207-282-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W COLE RD",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059458",
            "telephone_number": "207-282-3349",
            "fax_number": "207-282-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "NATHAN",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "012099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biddeford, ME

Sources for this page

Verify at the official NPI Registry.