Individual provider Active NPI

Rachel Elizabeth Wilson, M.D.

  • Vascular Surgery Physician
  • Orlando, FL
National Provider Identifier
1649665639
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME145052 Issued in FL
Practice address
2415 N Orange Ave Ste 302
Orlando, FL 32804-5505
Phone
(407) 303-7250
Fax
(407) 303-7255
NPI assigned
Apr 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Vascular Surgery Physician 2086S0129X ME145052 FL Primary

Addresses

Primary practice location

2415 N Orange Ave Ste 302
Orlando, FL 32804-5505

Mailing address

2415 N Orange Ave Ste 302
Orlando, FL 32804-5505
Phone (407) 303-7250

Other practice location 1

625 19th St S
Birmingham, AL 35249-1900
Phone (205) 934-2006

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200903000191 FL Practitioner - Vascular Surgery 9739467960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of South Florida College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2415 N Orange Ave
Suite 302
Orlando, FL 32804-5505
Phone (407) 303-7250

Hospital & facility affiliations

  • Family Home Care Group LLC Home health agency, Orlando, FL, CCN 103144
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Aug 17, 2020 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Aug 17, 2020 Accepting new patients
University of Alabama Health Services Foundation, PC. Past Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2415 N Orange Ave
Ste 302
Orlando, FL 32804
Phone (407) 303-7250

1925 Mizell Ave
Ste 306
Winter Park, FL 32792
Phone (407) 644-3866

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rwilson73887@adventhealth.direct-ci.com

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 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": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1649665639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 N ORANGE AVE STE 302",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045505",
            "telephone_number": "407-303-7250",
            "fax_number": "407-303-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 N ORANGE AVE STE 302",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045505",
            "telephone_number": "407-303-7250",
            "fax_number": "407-303-7255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352491900",
            "country_code": "US",
            "telephone_number": "205-934-2006",
            "fax_number": "205-934-0024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RACHEL",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME145052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.