Individual provider Active NPI

David D Wilson, MD

  • Radiation Oncology Physician
  • Philadelphia, PA
National Provider Identifier
1609010941
Registry record updated May 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD460063 Issued in PA
Practice address
51 N 39TH St
Philadelphia, PA 19104-2640
Phone
(215) 662-8000
NPI assigned
Apr 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X MD460063 PA Primary

Addresses

Primary practice location

51 N 39TH St
Philadelphia, PA 19104-2640

Mailing address

PO Box 800136
Charlottesville, VA 22908-0136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160719001738 NJ Practitioner - Radiation Oncology 9638306368 Reassigns benefits to 1 organization
I20170621000589 PA Practitioner - Radiation Oncology 9638306368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Rochester School of Medicine and Dentistry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinical Health Care Associates of New Jersey PCGroup PAC ID 0749180198, 793 clinicians

Practice addresses (Care Compare)

1865 Route 70 E
PPMC Infus
Cherry Hill, NJ 08003-2013
Phone (856) 429-1519

Hospital & facility affiliations

  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029
  • Virtua Willingboro Hospital Hospital, Willingboro, NJ, CCN 310061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD460063PAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, PC Radiation Oncology Current Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2017 Accepting new patients
University of Penn-Medical Group Radiation Oncology CurrentSince Jul 1, 2017 Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Jul 1, 2017 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Jul 1, 2017 Accepting new patients

Locations

1865 Route 70 E
Ste 220
Cherry Hill, NJ 08003
Phone (856) 429-0505

1865 Route 70 E
Cherry Hill, NJ 08003
Phone (856) 427-4336

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

350 Young Ave
Ste 100
Moorestown, NJ 08057
Phone (856) 206-4700

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

200 Bowman Dr
Ste D190
Voorhees, NJ 08043
Phone (215) 913-2921

Organizations & group practices 6

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 4

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": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495065600000",
    "number": "1609010941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800136",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DAVID",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-30",
        "last_updated": "2017-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "PA",
            "license": "MD460063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.