Individual provider Active NPI

Casey Lauren Wilkerson, MD

  • Obstetrics & Gynecology Physician
  • New York, NY
National Provider Identifier
1700452331
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
339997 Issued in NY
Practice address
568 Broadway RM 304
New York, NY 10012-3271
Phone
(212) 966-7600
NPI assigned
Jun 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 339997 NY Primary

Addresses

Primary practice location

568 Broadway RM 304
New York, NY 10012-3271

Mailing address

PO Box 81063
Cleveland, OH 44181-0063

Other practice location 1

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033-2414
Phone (323) 260-5781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20260212000451 NY Practitioner - Obstetrics/Gynecology 8729567466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of California, San Diego School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Square Care Medical Group LLPGroup PAC ID 7012938434, 70 clinicians

Practice addresses (Care Compare)

191 Herricks Rd
Garden City Park, NY 11040-5236
Phone (516) 742-2224

568 Broadway
RM 304
New York, NY 10012-3271
Phone (212) 966-7600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
339997NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Square Care Medical Group, LLP Obstetrics & Gynecology CurrentSince Oct 20, 2025 Accepting new patients

Locations

191 Herricks Rd
New Hyde Park, NY 11040
Phone (516) 248-0144

568 Broadway
Rm 304
New York, NY 10012
Phone (212) 966-7600

Interoperability endpoints

  • Direct secure messaging: casey.wilkerson.1@15987.direct.athenahealth.com
  • Direct secure messaging: cwilkerson767531@nyumc.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/15987/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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 7

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": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1700452331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81063",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441810063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 BROADWAY RM 304",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100123271",
            "telephone_number": "212-966-7600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 E Cesar E Chavez Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900332414",
            "country_code": "US",
            "telephone_number": "323-260-5781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "CASEY",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "339997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.