Mary Therese Wilson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

52951 Issued in MA

Practice address

114 State Rd
Sagamore Beach, MA 02562-2317

Phone

(801) 678-3317

NPI assigned

Feb 2, 2007

Sex

Female

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sagamore CounselingGroup PAC ID 2062855265, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Sagamore Counseling

  • Professional Counselor
  • Sagamore Beach, MA
  • NPI 1952943284
  Medicare reassignment Care Compare group NPD
• Saint Anthony House Treatment Programs

  • Community/Behavioral Health Agency
  • South Salt Lake, UT
  • NPI 1477985513
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1720126766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 STATE RD",
            "city": "SAGAMORE BEACH",
            "state": "MA",
            "postal_code": "025622317",
            "telephone_number": "801-678-3317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 STATE RD",
            "city": "SAGAMORE BEACH",
            "state": "MA",
            "postal_code": "025622317",
            "telephone_number": "801-678-3317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "258 Main St Ste C3",
            "address_purpose": "LOCATION",
            "city": "Buzzards Bay",
            "state": "MA",
            "postal_code": "025323253",
            "country_code": "US",
            "telephone_number": "508-333-1375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARY",
        "middle_name": "THERESE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "52951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sagamore Counseling
• Robert Santos Jr.
• Jose Sapia, D.M.D.
• Jeffrey Spruance
• Laura Ann Thompson, OTR/L
• John W Zavrid, R.N.

• Psychiatry Physician in Sagamore Beach, MA
• Providers in Sagamore Beach, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.