Individual provider Active NPI

Mark R Wilson, PA-C

  • Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1760824635
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA056202 Issued in PA
Practice address
1307 Federal St Ste 2
Pittsburgh, PA 15212-4769
Phone
(877) 660-6777
Fax
(412) 359-8055
NPI assigned
Jul 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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 MA056202 PA Primary

Addresses

Primary practice location

1307 Federal St Ste 2
Pittsburgh, PA 15212-4769

Mailing address

1307 Federal St Ste 2
Pittsburgh, PA 15212-4769
Phone (877) 660-6777

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwilson6650@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20130809000594 PA Practitioner - Physician Assistant 7012159676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allegheny ClinicGroup PAC ID 5395649586, 2,313 clinicians

Practice addresses (Care Compare)

12311 Perry Hwy
Wexford, PA 15090-8344
Phone (412) 359-3457

12351 Perry Hwy
Wexford, PA 15090-8344
Phone (412) 359-6581

1307 Federal St
Pittsburgh, PA 15212-4769

200 Quinn Dr
Pittsburgh, PA 15275-1055

2027 Lebanon Church Rd
West Mifflin, PA 15122-2461
Phone (412) 655-6500

20397 Route 19
Cranberry Township, PA 16066-6133
Phone (724) 772-3300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic CurrentSince Nov 19, 2014 Accepting new patients
Allegheny Clinic CurrentSince Nov 19, 2014 Accepting new patients
Allegheny Clinic Past Accepting new patients

Locations

2419 State Ave
Ste 200
Coraopolis, PA 15108
Phone (412) 625-2625

200 Quinn Dr
Ste 210
Pittsburgh, PA 15275
Phone (412) 294-1277

1307 Federal St
Ste 2
Pittsburgh, PA 15212
Phone (412) 330-4461

1307 Federal St
Fl 2
Pittsburgh, PA 15212
Phone (877) 660-9777

2027 Lebanon Church Rd
West Mifflin/Pleasant Hills, PA 15122
Phone (412) 655-8650

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 4

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": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1760824635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 FEDERAL ST STE 2",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124769",
            "telephone_number": "877-660-6777",
            "fax_number": "412-359-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 FEDERAL ST STE 2",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124769",
            "telephone_number": "877-660-6777",
            "fax_number": "412-359-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-22",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwilson6650@direct.ahn.org",
            "affiliation": "N",
            "address_1": "1307 Federal St Ste 2",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152124769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.