Michael A Wilson, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

MD15370 Issued in OR

Practice address

9427 SW Barnes Rd
Ste 498
Portland, OR 97225-6652

Phone

(503) 216-0900

NPI assigned

Jun 20, 2006

Last updated

Mar 25, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

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 2

Specialty

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine

Education

University of Michigan Medical School, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Providence Health and Services - OregonGroup PAC ID 9335057447, 212 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
• Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
• Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037
• Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
• Columbia Memorial Hospital Hospital, Astoria, OR, CCN 381320

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Health & Services Oregon

  dba Providence Medical Group

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Medicare reassignment Care Compare group
• Providence Health & Services - Oregon

  dba Providence Portland Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  dba Providence Medford Medical Center

  • Clinic/Center
  • Medford, OR
  • NPI 1093976243
  Medicare reassignment NPD
• Providence Health & Services Oregon

  dba Providence Medical Group South

  • Family Medicine Physician
  • Medford, OR
  • NPI 1568547503
  Medicare reassignment NPD
• Providence Health & Services Oregon

  dba Providence Seaside Hospital

  • Critical Access Hospital
  • Seaside, OR
  • NPI 1578500492
  Medicare reassignment NPD
• Providence Health & Services Oregon

  dba Prov Peds Neurology Longview

  • Pediatrics Physician
  • Longview, WA
  • NPI 1104097906
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  dba Providence Newberg Medical Center

  • General Acute Care Hospital
  • Newberg, OR
  • NPI 1952482275
  Medicare reassignment
• Providence Health & Services - Oregon

  dba Providence Medford Medical Center

  • Clinical Pathology Physician
  • Medford, OR
  • NPI 1285185942
  NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Portland, OR
  • NPI 1679826317
  NPD
• Providence Health & Services - Oregon

  dba Providence Seaside Hospital, Astoria Clinic

  • Clinic/Center
  • Astoria, OR
  • NPI 1851657035
  NPD
• Providence Health & Services - Oregon

  dba PMG South Eagle Point

  • Family Medicine Physician
  • Eagle Point, OR
  • NPI 1992031595
  NPD

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

• Columbia Lutheran Charities

  dba Columbia Memorial Hospital

  • Critical Access Hospital
  • Astoria, OR
  • NPI 1134146939
  Care Compare affiliation
• Columbia Lutheran Charities

  dba CMH Cardiology Clinic

  • Cardiovascular Disease Physician
  • Astoria, OR
  • NPI 1629378880

  Hospital

  Care Compare affiliation
• Columbia Lutheran Charities

  • Critical Access Hospital
  • Astoria, OR
  • NPI 1700809761
  Care Compare affiliation
• Columbia Lutheran Charities

  dba Columbia Memorial Hospital

  • Surgery Physician
  • Astoria, OR
  • NPI 1821254129

  Hospital

  Care Compare affiliation
• Columbia Lutheran Charities

  • Surgery Physician
  • Astoria, OR
  • NPI 1871747659

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Portland Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Clinic/Center
  • Portland, OR
  • NPI 1326272741

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  • Case Manager/Care Coordinator
  • Portland, OR
  • NPI 1891822995

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Willamette Falls Medical Center

  • General Acute Care Hospital
  • Oregon City, OR
  • NPI 1912282369
  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Newberg Medical Center

  • General Acute Care Hospital
  • Newberg, OR
  • NPI 1952482275
  Care Compare affiliation

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1871539973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9427 SW BARNES RD",
            "address_2": "STE 498",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256652",
            "telephone_number": "503-216-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD15370",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WA",
            "license": "MD00049331",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OR",
            "license": "MD15370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202895",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00848627",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00909394",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwilson107785@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9427 SW Barnes Rd Ste 495",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mark D Wilson, DMD
• Marni Wilson, LCSW
• Mary Wilson
• Mary Pearl Wilson, LMT
• Meredith Wilson
• Michael Lawrence Wilson, M.A.
• Mikayla Wilson
• Nicole Marie Wilson, D.C.
• Niema Wilson, LMT
• Paige Wilson

• Interventional Cardiology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Interventional Cardiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.