Individual provider Active NPI

Wilson Robinson, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1700394731
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19304 Issued in TX
Practice address
5601 Loch Raven Blvd BLDG Ste 206
Baltimore, MD 21239-2945
Phone
(443) 444-4700
NPI assigned
Jan 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C07159 MD
Physician Assistant 363A00000X PA19304 TX Primary

Addresses

Primary practice location

5601 Loch Raven Blvd BLDG Ste 206
Baltimore, MD 21239-2945

Mailing address

1287 Sims St
Gainesville, GA 30501-3851
Phone (678) 928-5954

Other practice location 1

703 S Fleishel Ave Ste 5000
Tyler, TX 75701-2015
Phone (903) 606-7525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190417002723 MD Practitioner - Physician Assistant 6103186309 Reassigns benefits to 2 organizations
I20250731000178 TX Practitioner - Physician Assistant 6103186309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians
Medstar Heart Institute LLCGroup PAC ID 5698932960, 308 clinicians

Practice addresses (Care Compare)

105 Zeid Blvd
Henderson, TX 75652-6070
Phone (903) 595-2283

1600 Broadway Ave
Gladewater, TX 75647-5040
Phone (903) 315-5630

1783 Troup Hwy
Tyler, TX 75701-5869
Phone (903) 595-2283

18780 Interstate 20
Canton, TX 75103-3593
Phone (903) 567-4841

3333 N Calvert St
Baltimore, MD 21218-2867
Phone (410) 261-8500

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

800 E Dawson St
Christus Trinity Clinic
Tyler, TX 75701-2036
Phone (903) 510-1186

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA19304TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Sep 15, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince May 26, 2019 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 15, 2025 Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients

Locations

5601 Loch Raven Blvd
Ste 206
Baltimore, MD 21239
Phone (410) 464-5600

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

703 S Fleishel Ave
Ste 5000
Tyler, TX 75701
Phone (903) 525-2992

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1700394731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1287 SIMS ST",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013851",
            "telephone_number": "678-928-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD BLDG STE 206",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392945",
            "telephone_number": "443-444-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 S Fleishel Ave Ste 5000",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012015",
            "country_code": "US",
            "telephone_number": "903-606-7525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "WILSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-11",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C07159",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.