Individual provider Active NPI

Chelsea Wilson, RT

  • Medical Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1447694658
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10000679A Issued in IN
Practice address
9998 Crosspoint Blvd Ste 200
Indianapolis, IN 46256-3307
Phone
(317) 806-8285
Fax
(317) 579-2130
NPI assigned
Apr 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10000679A IN Primary

Addresses

Primary practice location

9998 Crosspoint Blvd Ste 200
Indianapolis, IN 46256-3307

Mailing address

9998 Crosspoint Blvd Ste 200
Indianapolis, IN 46256-3307
Phone (317) 806-8285

Other identifiers 1

IdentifierTypeStateIssuer
300022799MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20190212001480 IN Practitioner - Physician Assistant 2466790753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Radiology of Indiana P CGroup PAC ID 0648161430, 122 clinicians

Practice addresses (Care Compare)

9998 Crosspoint Blvd
Suite 200
Indianapolis, IN 46256-3307
Phone (317) 579-2150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
72.2 of 100Reported as group
Quality
71.68
Improvement activities
40
Cost
59.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10000679AINMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients

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 3

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": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1447694658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9998 CROSSPOINT BLVD STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462563307",
            "telephone_number": "317-806-8285",
            "fax_number": "317-579-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9998 CROSSPOINT BLVD STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462563307",
            "telephone_number": "317-806-8285",
            "fax_number": "317-579-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHELSEA",
        "credential": "RT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-18",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10000679A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300022799",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.