Individual provider Active NPI

Sydney A Wilson, M.D.

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1467672964
Registry record updated Mar 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01063657A Issued in IN
Practice address
1800 N Capitol Ave
Noyes Pavilion E-140
Indianapolis, IN 46202-1218
Phone
(317) 962-8776
Fax
(317) 963-5285
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01063657A IN Primary

Addresses

Primary practice location

1800 N Capitol Ave
Noyes Pavilion E-140
Indianapolis, IN 46202-1218

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Other identifiers 2

IdentifierTypeStateIssuer
P00920825OtherINRAILROAD MEDICARE PTAN-CRITICAL CARE
200864930MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address swilso19@direct.iuhealth.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070525000388 IN Practitioner - HospitalistPractitioner - Internal Medicine 3173620127 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
University of Louisville School of Dentistry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01063657AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
Indiana Clinic Critical Care LLC Internal Medicine CurrentSince Feb 15, 2010 Accepting new patients
Major Hospital Past Accepting new patients

Locations

2574 Reliable Pkwy
Chicago, IL 60686

13500 N Meridian St
Carmel, IN 46032
Phone (317) 573-7000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1801 Senate Blvd
Ste 230
Indianapolis, IN 46202
Phone (317) 962-5280

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

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 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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741996800000",
    "number": "1467672964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N CAPITOL AVE",
            "address_2": "NOYES PAVILION E-140",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021218",
            "telephone_number": "317-962-8776",
            "fax_number": "317-963-5285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SYDNEY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2025-03-15",
        "certification_date": "2025-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01063657A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN-CRITICAL CARE",
            "identifier": "P00920825",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200864930",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swilso19@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1800 N Capitol Ave",
            "address_2": "Noyes Pavilion E-140",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.