Robert J Wilson, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3808 Padre Blvd
South Padre Island, TX 78597-7004

Phone

(956) 761-3996

Fax

(956) 761-6635

NPI assigned

Jul 2, 2009

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

Medicare fee-for-service enrollment

Enrolled in TX

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

Practice roles

Interoperability endpoints

• Direct secure messaging: robert.wilson@4217.securemail.prognocis.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.

• Antonio M. Diaz Jr Mdpa Inc.

  • Family Medicine Physician
  • Brownsville, TX
  • NPI 1386796258
  Medicare reassignment
• Spi Clinic, PLLC

  • Internal Medicine Physician
  • South Padre Island, TX
  • NPI 1699087650
  NPD (past)

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1902035678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E REPARO CIR",
            "city": "BAYVIEW",
            "state": "TX",
            "postal_code": "785664755",
            "telephone_number": "956-434-6398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 PADRE BLVD",
            "city": "SOUTH PADRE ISLAND",
            "state": "TX",
            "postal_code": "785977004",
            "telephone_number": "956-761-3996",
            "fax_number": "956-761-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunset Therapy, LLC
• Texas Medical Recovery Group PLLC
• Beatriz Trevino, MA VR COUNSELOR
• Aaron Norman Unterbrink, D.D.S.
• Melvin Scott Vandenburg, MA, MBA, LPC, LCDC
• Steeler Wright
• Martha Lee Zer, FNP

• Physician Assistant in South Padre Island, TX
• Providers in South Padre Island, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.