Individual provider Active NPI

Alicia Kelley Wilber, PA-C

  • Physician Assistant
  • Dover, NH
National Provider Identifier
1710407671
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
750 Central Ave Ste N
Dover, NH 03820-3434
Phone
(603) 749-2266
NPI assigned
Jun 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

750 Central Ave Ste N
Dover, NH 03820-3434

Mailing address

750 Central Ave Ste N
Dover, NH 03820-3434
Phone (603) 749-2266

Other identifiers 1

IdentifierTypeStateIssuer
456OtherNHOTHER CARRIER

Other names 1

  • Alicia Kelley Long Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20170801002290 NH Practitioner - Physician Assistant 2769753334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wentworth Douglass Physician CorporationGroup PAC ID 5496749848, 429 clinicians

Practice addresses (Care Compare)

789 Central Ave
Dover, NH 03820-2526

Hospital & facility affiliations

  • Wentworth-Douglass Hospital Hospital, Dover, NH, CCN 300018

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Apr 1, 2018 Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients
Westchester Neurological Consultant PC Past Accepting new patients

Locations

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

789 Central Ave
#1
Dover, NH 03820
Phone (603) 609-6260

750 Central Ave
Ste N
Dover, NH 03820
Phone (603) 740-6510

750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030

121 Corporate Dr
Bldg C
Portsmouth, NH 03801
Phone (603) 740-8787

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: wilber.alicia.wdh@direct.partners.masshiway.net

Organizations & group practices 4

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 2

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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1710407671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 CENTRAL AVE STE N",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203434",
            "telephone_number": "603-749-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 CENTRAL AVE STE N",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203434",
            "telephone_number": "603-749-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBER",
        "first_name": "ALICIA",
        "middle_name": "KELLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER CARRIER",
            "identifier": "456",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "LONG",
            "middle_name": "KELLEY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.