Kyle Andrew Wilson, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

5838 Issued in OK

Practice address

1725 E 19TH St Ste 401
Tulsa, OK 74104

Phone

(918) 749-1413

Fax

(918) 749-0234

NPI assigned

Apr 15, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

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

Obstetrics/Gynecology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stillwater Medical Center AuthorityGroup PAC ID 2365353794, 155 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Stillwater Medical Center Hospital, Stillwater, OK, CCN 370049

Merit-based Incentive Payment System (MIPS)

Final score

90.91 of 100Reported as apm

Quality

76.55

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kyle.wilson.p1@direct.smc.nextgenshare.com
• Direct secure messaging: kwilson119845@ahs.direct-ci.com
• Direct secure messaging: kyle.wilson@direct.stjohnhealthsystem.com

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.

• Stillwater Medical Center Authority

  • Family Medicine Physician
  • Stillwater, OK
  • NPI 1558377135

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Drumright Community Hospital LLC

  • Emergency Care Clinic/Center
  • Drumright, OK
  • NPI 1528696705
  Medicare reassignment NPD
• Obhg Oklahoma, P.C.

  • Obstetrics & Gynecology Physician
  • Tulsa, OK
  • NPI 1043595374
  Medicare reassignment NPD
• Stillwater Medical Center Authority

  • Family Medicine Physician
  • Perry, OK
  • NPI 1407729361
  NPD
• Stillwater Medical Center Authority

  • General Acute Care Hospital
  • Stillwater, OK
  • NPI 1164494027
  NPD (past)
• Stillwater Medical Center Physicians

  • Anesthesiology Physician
  • Stillwater, OK
  • NPI 1295859387
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Stillwater Medical Center Authority

  • General Acute Care Hospital
  • Stillwater, OK
  • NPI 1164494027
  Care Compare affiliation

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1841619905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 E 19TH ST STE 401",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045409",
            "telephone_number": "918-749-1413",
            "fax_number": "918-749-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 E 19TH ST STE 401",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-749-1413",
            "fax_number": "918-749-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KYLE",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "5838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200664660A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200774440A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keith Nathan Wilson
• Kelli Rae Lee Wilson, RD, PLD
• Kellie Ann Wilson
• Kendra Wilson, DO
• Kimberly Ann Wilson, MSN, APRN-CNP, NP-C
• Kylee Alexis Wilson
• Ladamian Kawon Wilson, DPT
• Lakia Dawn Wilson, LCSW
• Laura Wilson, PHD
• Lauren Elizabeth Wilson

• Obstetrics & Gynecology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Obstetrics & Gynecology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; 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.