Individual provider Active NPI

Elisabeth Brayton Wilson, MD

  • Family Medicine Physician
  • Edison, NJ
National Provider Identifier
1417973587
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA12963000 Issued in NJ
Practice address
65 James St
Edison, NJ 08820-3947
Phone
(732) 321-7000
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA12963000 NJ Primary

Addresses

Primary practice location

65 James St
Edison, NJ 08820-3947

Mailing address

65 James St
Edison, NJ 08820-3947
Phone (732) 321-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220217002369 NH Practitioner - Family Practice 9032371208 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

18 Old Etna Rd
Lebanon, NH 03766-1937
Phone (603) 650-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
70067CAMDClinical Social Worker
25MA12963000NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic CurrentSince Jan 28, 2022 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jan 28, 2022 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jan 28, 2022 Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

18 Old Etna Rd
Lebanon, NH 03766
Phone (603) 650-3100

Organizations & group practices 3

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 2

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1417973587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ELISABETH",
        "middle_name": "BRAYTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA12963000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.