Individual provider Active NPI

Max Wilkinson, PA-C

  • Physician Assistant
  • Lewes, DE
National Provider Identifier
1467068528
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C5-0011432 Issued in DE
Practice address
424 Savannah Rd
Lewes, DE 19958-1462
Phone
(302) 645-3300
NPI assigned
Sep 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C5-0011432 DE Primary

Addresses

Primary practice location

424 Savannah Rd
Lewes, DE 19958-1462

Mailing address

31214 Brush Hook Rd
Ocean View, DE 19970-3506
Phone (302) 858-3997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20210120000189 DE Practitioner - Physician Assistant 8729491493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Atracare Walk-in LLCGroup PAC ID 4486029592, 20 clinicians

Practice addresses (Care Compare)

18068 Coastal Hwy
Lewes, DE 19958-4901
Phone (302) 567-1500

Hospital & facility affiliations

  • Beebe Medical Center Hospital, Lewes, DE, CCN 080007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C5-0011432DEMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: mwilkinson22809@beebehealth.direct-ci.com

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": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1467068528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31214 BRUSH HOOK RD",
            "city": "OCEAN VIEW",
            "state": "DE",
            "postal_code": "199703506",
            "telephone_number": "302-858-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 SAVANNAH RD",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199581462",
            "telephone_number": "302-645-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "MAX",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0011432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewes, DE

Sources for this page

Verify at the official NPI Registry.