Shruti Priyanka Wilson, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

267028 Issued in MA

Practice address

55 Fruit St
Boston, MA 02114-2621

Phone

(617) 726-8707

NPI assigned

Apr 16, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wilson.shruti.nwh@direct.partners.masshiway.net

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.

• Massachusetts General Physicians Organization Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1801874573
  Medicare reassignment NPD
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236

  Allergy & Immunology

  Medicare reassignment NPD
• Newton Wellesley Hospital

  • General Acute Care Hospital
  • Newton, MA
  • NPI 1952845521
  NPD

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1861666224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 MILK ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021094806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-8707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Wall St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018034758",
            "country_code": "US",
            "telephone_number": "781-221-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHRUTI",
        "middle_name": "PRIYANKA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "A119432",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MA",
            "license": "267028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Wilson
• Samantha Teresa Wilson, PA-C
• Scott Maxwell Wilson
• Scott Numo Wilson, MD
• Sean Wilson, M.D.
• Stephen A Wilson, MD
• Tommy John Wilson, MD-PHD
• Trevor C Wilson
• Whitney Wilson, PSYD
• Eric James Wilsterman Jr., M.D.

• Allergy & Immunology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Allergy & Immunology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.