NPIMap

Individual provider Active NPI

James E Wilson, PA-C

  • Medical Physician Assistant
  • Port St Lucie, FL
National Provider Identifier
1912936436
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9102360 Issued in FL
Practice address
513 NW Lake Whitney PL Ste 101
Port St Lucie, FL 34986-1618
Phone
(772) 344-7228
Fax
(772) 344-7158
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9102360 FL Primary

Addresses

Primary practice location

513 NW Lake Whitney PL Ste 101
Port St Lucie, FL 34986-1618

Mailing address

513 NW Lake Whitney PL Ste 101
Port St Lucie, FL 34986-1618
Phone (772) 344-7228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040207000215 FL Practitioner - Physician Assistant 2062305485 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2940 S US Hwy 1
Suite C11 Wellmed at Fort Pierce
Fort Pierce, FL 34982-8143
Phone (772) 466-6855

513 NW Lake Whitney Place
Suite 101 Wellmed at Port St. Lucie West
Port St Lucie, FL 34986-1618
Phone (772) 344-7228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Town & Country Emergency Physicians LLC Past Accepting new patients
Oakfield Drive Emergency Physicians LLC Past Accepting new patients

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: james.wilson@wellmed.eclinicaldirectplus.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1912936436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 NW LAKE WHITNEY PL STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861618",
            "telephone_number": "772-344-7228",
            "fax_number": "772-344-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 NW LAKE WHITNEY PL STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861618",
            "telephone_number": "772-344-7228",
            "fax_number": "772-344-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JAMES",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.