Khare Wilson, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA4863 Issued in MA

Practice address

330 Brookline Ave
Boston, MA 02215-5400

Phone

(617) 667-7672

NPI assigned

Nov 11, 2013

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

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cambridge Public Health CommissionGroup PAC ID 8921910894, 654 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cambridge Health Alliance Hospital, Cambridge, MA, CCN 220011

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwilson116580@direct.challiance.masshiway.net

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.

• Cambridge Public Health Commission

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1932313228
  Medicare reassignment Care Compare group NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Orthopaedic Surgery Physician
  • Boston, MA
  • NPI 1972544591
  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  Medicare reassignment NPD
• Cambridge Public Health Commission

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1487603585
  NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Emergency Medicine Physician
  • Boston, MA
  • NPI 1316987993
  NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD

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

• Cambridge Public Health Commission

  • Clinic/Center
  • Cambridge, MA
  • NPI 1306908405

  Hospital

  Care Compare affiliation
• Cambridge Public Health Commission

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1487603585
  Care Compare affiliation

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384128000000",
    "number": "1689003675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 TRASK AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697409",
            "telephone_number": "617-833-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-7672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KHARE",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-11",
        "last_updated": "2013-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA4863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Grace Wilson, DNP
• Justin Wilson
• Kathryn Clare Wilson, MS, RD, LDN, CNSC
• Kayla Tenniel Wilson I
• Kevin C. Wilson, MD
• Lauren Elizabeth Wilson, NP
• Leah Wilson
• Lesia Barbara Wilson, DPT
• Lianna Wilson, PH.D.
• Lindsey Jane Wilson, LICSW

• Surgical Physician Assistant in Boston, MA
• Providers in Boston, MA by specialty
• Surgical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.