Niamey Susannah Wilson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

53269 Issued in CT

Practice address

114 Woodland St
Comprehensive Women'S Health Center-Breast Center
Hartford, CT 06105-1208

Phone

(860) 714-6318

Fax

(860) 714-9990

NPI assigned

Jan 5, 2007

Sex

Female

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 CT

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

Surgical OncologyAlso: General Surgery

Education

Columbia University College of Physicians and Surgeons, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Midstate Medical Center Hospital, Meriden, CT, CCN 070017

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: niamey.wilson@xdr.hhchealthdirect.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.

• Hartford Healthcare Medical Group Specialists, PLLC

  • Surgery Physician
  • Hartford, CT
  • NPI 1023584216
  Medicare reassignment Care Compare group NPD
• Hartford Healthcare Medical Group, Inc

  • Surgery Physician
  • Wethersfield, CT
  • NPI 1043561301
  Medicare reassignment NPD
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812
  Medicare reassignment NPD
• Hartford Healthcare Medical Group Specialists LLC

  • Customized Equipment (DME)
  • Groton, CT
  • NPI 1295367068
  NPD
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD

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

• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1427007848
  Care Compare affiliation
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1669524187
  Care Compare affiliation

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1942357496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 LEWIS AVE",
            "address_2": "STE 203",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512121",
            "telephone_number": "860-714-6318",
            "fax_number": "860-714-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "address_2": "COMPREHENSIVE WOMEN'S HEALTH CENTER-BREAST CENTER",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-6318",
            "fax_number": "860-714-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "NIAMEY",
        "middle_name": "SUSANNAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT188433",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CT",
            "license": "53269",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "53269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dionne I Wilson, RN
• Emmett E Wilson, DDS
• Gary Wilson, MD
• Heather Lynne Wilson, APRN
• Kathryn E Wilson
• Sweets Wilson, MSW, PH.D., LADC
• Theo Wilson, PT
• Emma Wentworth Winchester, DMD, PHD
• Mary Hyde Windels, MD
• Samantha Ann Windoloski, PA-C

• Surgery Physician in Hartford, CT
• Providers in Hartford, CT by specialty
• Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; 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.