Individual provider Active NPI

Michael George Wilkerson, MD

  • Dermatology Physician
  • Galveston, TX
National Provider Identifier
1437217130
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G9010 Issued in TX
Practice address
400 Harborside Dr
Galveston, TX 77555-0001
Phone
(409) 772-2222
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G9010 TX Primary

Addresses

Primary practice location

400 Harborside Dr
Galveston, TX 77555-0001

Mailing address

301 University Blvd
RT 1022
Galveston, TX 77555-5302
Phone (409) 772-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20051012001088 TX Practitioner - Dermatology 4284601873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical School at Houston, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-2222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.88 of 100Reported as group
Quality
73.38
Improvement activities
40
Cost
78.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions576
Skin biopsy98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G9010TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice Dermatology CurrentSince Dec 1, 2005 Accepting new patients
Ahs Oklahoma Physician Group LLC Past Accepting new patients

Locations

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

301 University Blvd
#1022
Galveston, TX 77555
Phone (409) 772-0848

2785 Gulf Fwy S
Ste 165
League City, TX 77573
Phone (832) 505-0139

9300 Emmett F Lowry Expy
Ste 138
Texas City, TX 77591
Phone (409) 486-9686

Interoperability endpoints

  • Direct secure messaging: mwilkersonmd11588@direct.utmb.edu
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 2

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 1

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1437217130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "address_2": "RT 1022",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-772-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HARBORSIDE DR",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550001",
            "telephone_number": "409-772-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "MICHAEL",
        "middle_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "G9010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.