Individual provider Active NPI

Janice May Wilson, M.D.

  • Dermatology Physician
  • Galveston, TX
National Provider Identifier
1457612749
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
BP20046284 Issued in TX
Practice address
301 University Blvd
University of Texas Medical Branch-Dermatology
Galveston, TX 77555-0783
Phone
(409) 772-1911
Fax
(409) 772-4456
NPI assigned
Jun 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X Q5126 TX
Internal Medicine Physician 207R00000X BP10044148 TX
Dermatology Physician 207N00000X BP20046284 TX Primary

Addresses

Primary practice location

301 University Blvd
University of Texas Medical Branch-Dermatology
Galveston, TX 77555-0783

Mailing address

301 University Blvd
Galveston, TX 77555-0783
Phone (409) 772-1911

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
I20160628000770 TX Practitioner - Dermatology 9133410806 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Motaz Albahra, MD. P.a., PLLCGroup PAC ID 3678576006, 4 clinicians
Adg Houston Path PLLCGroup PAC ID 6901283621, 9 clinicians
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

2525 W Bellfort Ave
Suite 194
Houston, TX 77054-5099
Phone (281) 661-1573

2660 Gulf Fwy S
League City, TX 77573-6820

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

PO Box
650859 Dept 710
Dallas, TX 75265-0859

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 lesions360
Skin biopsy93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP20046284TXMDDermatology Physician
BP10044148TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice Dermatology CurrentSince Jun 10, 2016 Accepting new patients
Motaz Albahra, MD. P.a., PLLC CurrentSince Aug 22, 2022 Accepting new patients
Adg Houston Path PLLC CurrentSince Jul 1, 2022 Accepting new patients
Motaz Albahra, MD. P.a., PLLC CurrentSince Aug 22, 2022 Accepting new patients
Adg Houston Path PLLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

301 University Blvd
Bldg 4TH
Galveston, TX 77555
Phone (281) 661-1573

301 University Blvd
Bldg 4
Galveston, TX 77555

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

2525 W Bellfort Ave
Ste 194
Houston, TX 77054
Phone (281) 661-1573

2660 Gulf Fwy S
#A
League City, TX 77573
Phone (832) 505-2200

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

2001 N Jefferson Ave
Mt Pleasant, TX 75455
Phone (903) 434-8044

Organizations & group practices 5

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": "1338681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1457612749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550783",
            "telephone_number": "409-772-1911",
            "fax_number": "409-772-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "address_2": "UNIVERSITY OF TEXAS MEDICAL BRANCH-DERMATOLOGY",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550783",
            "telephone_number": "409-772-1911",
            "fax_number": "409-772-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JANICE",
        "middle_name": "MAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-03",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "TX",
            "license": "Q5126",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10044148",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "BP20046284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.