Individual provider Active NPI

Lisa Kataria Wilson, APRN

  • Family Nurse Practitioner
  • Delray Beach, FL
National Provider Identifier
1619305166
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9262636 Issued in FL
Practice address
1690 S Federal Hwy
Delray Beach, FL 33483-5030
Phone
(561) 272-1163
NPI assigned
Oct 18, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9262636 FL Primary

Addresses

Primary practice location

1690 S Federal Hwy
Delray Beach, FL 33483-5030

Mailing address

1690 S Federal Hwy
Delray Beach, FL 33483-5030
Phone (561) 272-1163

Other practice location 1

3599 W Hillsboro Blvd
Deerfield Beach, FL 33442-9404
Phone (954) 333-5214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20140109001312 FL Practitioner - Nurse Practitioner 6103054580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

12401 Miramar Pkwy
Miramar, FL 33027-2900
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN9262636FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince May 12, 2014 Accepting new patients
Primary Care PLLC Family CurrentSince Nov 5, 2024 Accepting new patients

Locations

650 N Congress Ave
Boynton Beach, FL 33426
Phone (561) 396-2202

5800 S University Dr
Davie, FL 33328
Phone (954) 252-2583

3599 W Hillsboro Blvd
Deerfield Beach, FL 33442
Phone (954) 333-5214

1690 S Federal Hwy
Delray Beach, FL 33483
Phone (561) 272-1163

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

8740 SW 40th St
Miami, FL 33165
Phone (305) 221-8337

12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473

8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840

1501 S Federal Hwy
Pompano Beach, FL 33062
Phone (954) 788-0739

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

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.

NPI Registry JSON

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1619305166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 S FEDERAL HWY",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334835030",
            "telephone_number": "561-272-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 S FEDERAL HWY",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334835030",
            "telephone_number": "561-272-1163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3599 W Hillsboro Blvd",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "334429404",
            "country_code": "US",
            "telephone_number": "954-333-5214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LISA",
        "middle_name": "KATARIA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-18",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9262636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.