Individual provider Active NPI

David B Wilson, MD

  • Pediatric Hematology & Oncology Physician
  • Saint Louis, MO
National Provider Identifier
1942228440
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
103195 Issued in MO
Practice address
1 Childrens PL
Div Ped Hematology and Onc
Saint Louis, MO 63110-1002
Phone
(314) 454-6018
Fax
(844) 621-4392
NPI assigned
Jul 17, 2006
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 103195 MO
Pediatric Hematology & Oncology Physician 2080P0207X 103195 MO Primary

Addresses

Primary practice location

1 Childrens PL
Div Ped Hematology and Onc
Saint Louis, MO 63110-1002

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 454-6018

Other identifiers 1

IdentifierTypeStateIssuer
206704702MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20040608000340 MO Practitioner - Hematology/OncologyPractitioner - Pediatric Medicine 4981687449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Jun 17, 2010 Accepting new patients
Washington University CurrentSince Jun 17, 2010 Accepting new patients
Washington University Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
St. Louis Children's Hospital Past Accepting new patients

Locations

1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076

1 Childrens Pl
#8116
Saint Louis, MO 63110
Phone (314) 454-6095

1 Childrens Pl
Ste C
Saint Louis, MO 63110
Phone (314) 454-2104

13001 North Outer 40 Rd
Ste 2E
Town and Country, MO 63017
Phone (314) 454-3220

Interoperability endpoints

  • Direct secure messaging: dwilson167519@direct.carenet.org
  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1942228440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-454-6018",
            "fax_number": "844-621-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "DIV PED HEMATOLOGY AND ONC",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6018",
            "fax_number": "844-621-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "103195",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "MO",
            "license": "103195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206704702",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Childrens Pl",
            "address_2": "Div Ped Hematology and Onc",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.