Individual provider Active NPI

Elle Wilson, PA-C

  • Medical Physician Assistant
  • Beavercreek, OH
National Provider Identifier
1487376547
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50007805RX Issued in OH
Practice address
38 Woodcroft TRL
Beavercreek, OH 45430-1980
Phone
(937) 427-3333
NPI assigned
Sep 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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 50007805RX OH Primary

Addresses

Primary practice location

38 Woodcroft TRL
Beavercreek, OH 45430-1980

Mailing address

38 Woodcroft TRL
Beavercreek, OH 45430-1980
Phone (937) 427-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20221003002206 OH Practitioner - Physician Assistant 4688050321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mvhe IncGroup PAC ID 9537066584, 399 clinicians

Practice addresses (Care Compare)

2180 Gateway Dr
Fairborn, OH 45324-6356
Phone (937) 208-8155

2451 Wayne Ave
Dayton, OH 45420-1893
Phone (937) 252-1831

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
83.64
Promoting interoperability
100
Improvement activities
40
Cost
73.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50007805RXOHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Group, Inc. CurrentSince Oct 3, 2022 Accepting new patients
Mvhe Inc CurrentSince Aug 26, 2024 Accepting new patients
Providence Medical Group Medical CurrentSince Oct 3, 2022 Accepting new patients
Mvhe Inc CurrentSince Aug 26, 2024 Accepting new patients

Locations

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

38 Woodcroft Trl
Dayton, OH 45430
Phone (937) 427-3333

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

2180 Gateway Dr
Fairborn, OH 45324
Phone (937) 208-8155

2912 Springboro W
Ste 201
Moraine, OH 45439
Phone (937) 297-8996

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 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": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1487376547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 WOODCROFT TRL",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454301980",
            "telephone_number": "937-427-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 WOODCROFT TRL",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454301980",
            "telephone_number": "937-427-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50007805RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.