Scott Numo Wilson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

51507 Issued in MA

Practice address

5 Longfellow PL
Suite 213
Boston, MA 02114-2839

Phone

(617) 964-7309

Fax

(617) 742-6954

NPI assigned

Oct 26, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Aug 25, 2020 through Aug 25, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: wilson.scott.mgh@direct.partners.masshiway.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• General Hospital Corp

  dba Massachusetts General Hospital Outpatient Pharmacy

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1508390014
  NPD

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659361103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LONGFELLOW PL",
            "address_2": "SUITE 213",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142839",
            "telephone_number": "617-964-7309",
            "fax_number": "617-742-6954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 LONGFELLOW PL",
            "address_2": "SUITE 213",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142839",
            "telephone_number": "617-964-7309",
            "fax_number": "617-742-6954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SCOTT",
        "middle_name": "NUMO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "51507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "051507",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J03672",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Wilson, PA-C
• Roger J Wilson, O.D.
• Samantha Wilson
• Samantha Teresa Wilson, PA-C
• Scott Maxwell Wilson
• Sean Wilson, M.D.
• Shruti Priyanka Wilson, M.D.
• Stephen A Wilson, MD
• Tommy John Wilson, MD-PHD
• Trevor C Wilson

• Psychiatry Physician in Boston, MA
• Providers in Boston, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.