Victoria E Wilson

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9106455 Issued in FL

Practice address

2900 N Military TRL Ste 241
Boca Raton, FL 33431-6347

Phone

(561) 235-7666

Fax

(561) 948-0989

NPI assigned

Mar 8, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Medication Assisted Recovery Institute, LLC

  • Addiction Medicine (Preventive Medicine) Physician
  • Boca Raton, FL
  • NPI 1154967891
  Medicare reassignment

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1881968840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 CHAMPION BLVD STE G11-535",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962473",
            "telephone_number": "561-235-7666",
            "fax_number": "561-948-0989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N MILITARY TRL STE 241",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316347",
            "telephone_number": "561-235-7666",
            "fax_number": "561-948-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "VICTORIA",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-08",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Louise Williamson
• Dellissa Willis
• Griffin Willman
• Alyssa Wilson
• Madison Wilson, MD
• Sasha A Winderbaum, DDS
• Jaime Windrow, RD
• Alison Wing, PA-C
• Matthew Charles Winke, DACM, AP
• Fawn Winkelman, DO

• Physician Assistant in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.