NPIMap

Individual provider Active NPI

Jonathan M Wilson, MD

  • Family Medicine Physician
  • Mt Pleasant, PA
National Provider Identifier
1568406676
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD044652L Issued in PA
Practice address
508 S Church St Ste 100
Mt Pleasant, PA 15666-1702
Phone
(724) 547-4536
Fax
(724) 547-3799
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD044652L PA Primary

Addresses

Primary practice location

508 S Church St Ste 100
Mt Pleasant, PA 15666-1702

Mailing address

508 S Church St Ste 100
Mt Pleasant, PA 15666-1702
Phone (724) 547-4536

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jonathanwilson@emg.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100712000082 PA Practitioner - Family Practice 2062544034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

508 S Church St
Suite 100 Excela SQ Frick Family Medicine
Mt Pleasant, PA 15666-1702
Phone (724) 547-4536

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Excela Health Physician Practices, Inc. Family Medicine CurrentSince Mar 1, 2019 Accepting new patients
Excela Health Physician Practices, Inc Current Accepting new patients
Excela Health Physician Practices, Inc.. Family Medicine CurrentSince Mar 1, 2019 Accepting new patients
Excela Health Physician Practices, Inc Past Accepting new patients
Latrobe Area Hospital, Inc. Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Latrobe Area Hospital, Inc. Family Medicine Past Accepting new patients

Locations

532 W Pittsburgh St
Greensburg, PA 15601
Phone (724) 832-4000

1 Mellon Way
Latrobe, PA 15650
Phone (724) 537-1207

508 S Church St
Ste 100
Mt Pleasant, PA 15666
Phone (724) 547-4536

Organizations & group practices 7

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 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1568406676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 S CHURCH ST STE 100",
            "city": "MT PLEASANT",
            "state": "PA",
            "postal_code": "156661702",
            "telephone_number": "724-547-4536",
            "fax_number": "724-547-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S CHURCH ST STE 100",
            "city": "MT PLEASANT",
            "state": "PA",
            "postal_code": "156661702",
            "telephone_number": "724-547-4536",
            "fax_number": "724-547-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JONATHAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD044652L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jonathanwilson@emg.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "ESFFM Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "508 S Church St Ste 100",
            "city": "MT Pleasant",
            "state": "PA",
            "country_code": "US",
            "postal_code": "156661702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mt Pleasant, PA

Sources for this page

Verify at the official NPI Registry.