Peter John Wiltse, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G8514 Issued in TX

Practice address

3608 Preston Rd
Ste 150
Plano, TX 75093-8655

Phone

(972) 566-4040

Fax

(972) 769-0884

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

No

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

Enrolled in TX

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

Specialty

General Surgery

Education

University of North Texas HSC, College of Osteopathic Med, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCH TraumacareGroup PAC ID 4486036662, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical Center Hospital Hospital, Odessa, TX, CCN 450132

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Physician Assistant

State licenses

Practice roles

Locations

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.

• MCH Traumacare

  • Surgery Physician
  • Odessa, TX
  • NPI 1043956915
  Medicare reassignment Care Compare group NPD

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

• Ector County Hospital District

  • Federally Qualified Health Center (FQHC)
  • Odessa, TX
  • NPI 1578265302

  Hospital

  Care Compare affiliation
• Ector County Hospital District

  • General Acute Care Hospital
  • Odessa, TX
  • NPI 1740273994
  Care Compare affiliation

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1699770552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3608 PRESTON RD",
            "address_2": "SUITE 150",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938655",
            "telephone_number": "972-566-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3608 PRESTON RD",
            "address_2": "STE 150",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938655",
            "telephone_number": "972-566-4040",
            "fax_number": "972-769-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILTSE",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "G8514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8R5383",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032033502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Logan Blaze Wilson, FNP-C
• Rick Wilson, M.D.
• Rose Mary Wilson, DPM
• Taleesha Wilson
• Taylor Ross Wilson
• Win With Wellness,LLC
• Windhaven Adolescent Medicine
• Windhaven Medical Imaging.LLC
• Windhaven Pediatrics, LLP
• Windhaven Surgery Center, LLC

• Surgery Physician in Plano, TX
• Providers in Plano, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.