Individual provider Active NPI

Bo Alan Wilkinson, PA-C

  • Surgical Physician Assistant
  • Salisbury, MD
National Provider Identifier
1861913311
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
1675 Woodbrooke Dr
Salisbury, MD 21804-8502
Phone
(410) 749-4154
Fax
(410) 860-4515
NPI assigned
Jul 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

1675 Woodbrooke Dr
Salisbury, MD 21804-8502

Mailing address

PO Box 69709
Baltimore, MD 21264-9709
Phone (410) 749-4154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170808000641 MD Practitioner - Physician Assistant 7719258862 Reassigns benefits to 2 organizations
I20171114000537 DE Practitioner - Physician Assistant 7719258862 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians
Peninsula Orthopaedic Assoc PAGroup PAC ID 6406844406, 56 clinicians

Practice addresses (Care Compare)

100 E Carroll St
Salisbury, MD 21801-5422

1675 Woodbrooke Dr
Salisbury, MD 21804-8502
Phone (410) 749-4154

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Orthopaedic Assoc, PA Orthopaedic Surgery CurrentSince Jul 17, 2017 Accepting new patients

Locations

30265 Commerce Dr
Unit 104
Millsboro, DE 19966
Phone (302) 629-4787

801 Middleford Rd
Seaford, DE 19973
Phone (302) 628-9178

503 Health Services Dr
Seaford, DE 19973

11107 Cathage Rd
Unit 101
Ocean Pines, MD 21811
Phone (410) 641-0202

1675 Woodbrooke Dr
Salisbury, MD 21804
Phone (410) 860-4514

Organizations & group practices 3

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 2

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": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1861913311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69709",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212649709",
            "telephone_number": "410-749-4154",
            "fax_number": "410-860-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 WOODBROOKE DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218048502",
            "telephone_number": "410-749-4154",
            "fax_number": "410-860-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "BO",
        "middle_name": "ALAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.