Individual provider Active NPI

Mark S Wilson, MD

  • Anesthesiology Physician
  • San Antonio, TX
National Provider Identifier
1831287267
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
L5615 Issued in TX
Practice address
11212 State Highway 151
San Antonio, TX 78251-4498
Phone
(361) 985-1221
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X L5615 TX Primary

Addresses

Primary practice location

11212 State Highway 151
San Antonio, TX 78251-4498

Mailing address

PO Box 6696
Corpus Christi, TX 78466-6696
Phone (361) 985-1221

Other identifiers 1

IdentifierTypeStateIssuer
154048603MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050628001435 TX Practitioner - Anesthesiology 4587616420 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Wisconsin, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

600 Elizabeth St
Christus Spohn Hospital Corpus Christi SH
Corpus Christi, TX 78404-2235
Phone (361) 881-3657

Hospital & facility affiliations

  • CHI St Lukes Health Memorial Lufkin Hospital, Lufkin, TX, CCN 450211
  • Christus Santa Rosa Hospital-San Marcos Hospital, San Marcos, TX, CCN 450272

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia, PA Anesthesiology CurrentSince May 15, 2017 Accepting new patients
Emergenchealth PLLC Anesthesiology CurrentSince Jun 1, 2018 Accepting new patients
Northstar Anesthesia II PA Anesthesiology CurrentSince Jun 1, 2018 Accepting new patients
Premier Anesthesia of Corpus Anesthesiology Past Accepting new patients
Luis Felipe Flores, M.D., PLLC Past Accepting new patients

Locations

14425 Falcon Head Blvd
#11
Austin, TX 78738
Phone (512) 900-1006

3080 College St
#T
Beaumont, TX 77701
Phone (409) 212-5002

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

600 Elizabeth St
Corpus Christi, TX 78404
Phone (361) 325-2511

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

7101 S Padre Island Dr
Corpus Christi, TX 78412
Phone (361) 761-1400

6949 Bryant Irvin Rd
Ste 110
Ft Worth, TX 76132
Phone (817) 332-1818

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

6800 N MacArthur Blvd
Irving, TX 75039
Phone (972) 969-2000

4600 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 853-9302

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

11212 State Highway 151
San Antonio, TX 78251
Phone (210) 281-5066

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1831287267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6696",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784666696",
            "telephone_number": "361-985-1221",
            "fax_number": "361-985-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11212 STATE HIGHWAY 151",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514498",
            "telephone_number": "361-985-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "L5615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154048603",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.