Active NPI
McKenna Leigh Wilson, PA
- Physician Assistant
- Plainfield, NJ
National Provider Identifier
1902494065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 028008
- Practice address
- 1080 Oakland Ave
Plainfield, NJ 07060-3434 - Phone
- (908) 255-8626
- NPI assigned
- Jan 5, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 028008 | NY | Primary |
Addresses
Primary practice location
1080 Oakland Ave
Plainfield, NJ 07060-3434
Mailing address
1080 Oakland Ave
Plainfield, NJ 07060-3434
Phone (908) 255-8626
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220330000885 | NY | Practitioner - Physician Assistant | 0345636403 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- New York University
Practice addresses (Care Compare)
111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700
259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600
Hospital & facility affiliations
- NYU Langone Hospitals
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.8 of 100
- Quality
- 91.79
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.18
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Current | Accepting new patients |
Locations
13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Interoperability endpoints
- mckenna.wilson.1@22900.direct.athenahealth.com
- mwilson432390@nyumc.direct-ci.com
Organizations & group practices 2
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.
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
Hospital & facility affiliations 7
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": "1609804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1902494065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1080 OAKLAND AVE",
"city": "PLAINFIELD",
"state": "NJ",
"postal_code": "070603434",
"telephone_number": "908-255-8626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1080 OAKLAND AVE",
"city": "PLAINFIELD",
"state": "NJ",
"postal_code": "070603434",
"telephone_number": "908-255-8626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MCKENNA",
"middle_name": "LEIGH",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-05",
"last_updated": "2022-07-21",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "028008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plainfield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.