Michael E Wilson, MD

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

ME145800 Issued in FL

Practice address

303 N Clyde Morris Blvd
Intensivist Services
Daytona Beach, FL 32114-2709

Phone

(386) 425-4152

Fax

(386) 425-4315

NPI assigned

Sep 8, 2009

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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Oregon Health Sciences University School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Halifax Healthcare Systems IncGroup PAC ID 1254238090, 345 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (1 of 3)

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: mwilson142726@ehrdirect.mayoclinicmsg.org

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.

• Halifax Healthcare Systems Inc

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530

  Critical Care Medicine, FL

  Medicare reassignment Care Compare group NPD

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

• Halifax Hospital Medical Center

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1811991227

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1932432002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "address_2": "CREDENTIAL SERVICES",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-425-4152",
            "fax_number": "386-425-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "address_2": "INTENSIVIST SERVICES",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-425-4152",
            "fax_number": "386-425-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "53237",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MN",
            "license": "53237",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME145800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Wilson
• Chester Wilson Jr., EDD, CAP, CMHP
• Gary A Wilson, M. D.
• Jacob Thomas Wilson, MD
• Marcia Wilson
• Patricia Wilson, DDS
• Sandra Lynn Wilson
• Tara D Wilson, MD
• Tonya Renae Wilson, DNP, PMHNP-BC
• Vance Eugene Wilson, MD

• Critical Care Medicine (Internal Medicine) Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Critical Care Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.
• 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.