Richard C Wilson, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO1322 Issued in FL

Practice address

1515 Dr Martin Luther King Jr Blvd
Melbourne, FL 32901-2946

Phone

(321) 723-3500

Fax

(321) 723-1945

NPI assigned

Nov 30, 2005

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

Other identifiers 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Melbourne Podiatry Associates, P.a.Group PAC ID 2769567882, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019

Merit-based Incentive Payment System (MIPS)

Final score

97.5 of 100Reported as group

Quality

95

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rwilson71592@epicdirect.hf.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.

• Melbourne Podiatry Associates, P.a.

  • Podiatrist
  • Melbourne, FL
  • NPI 1174506877
  Medicare reassignment Care Compare group NPD
• Briant G. Moyles D.P.M., P.a.

  • Podiatrist
  • Melbourne, FL
  • NPI 1194998286
  NPD Authorized official

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

• Holmes Regional Medical Center, Inc.

  • Air Ambulance
  • Melbourne, FL
  • NPI 1235312281

  Hospital

  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1295702728
  Care Compare affiliation

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1972587350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 DR MARTIN LUTHER KING JR BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012946",
            "telephone_number": "321-723-3500",
            "fax_number": "321-723-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 DR MARTIN LUTHER KING JR BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012946",
            "telephone_number": "321-723-3500",
            "fax_number": "321-723-1945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 W Eau Gallie Blvd Ste E",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329355300",
            "country_code": "US",
            "telephone_number": "321-255-3338",
            "fax_number": "321-253-9643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RICHARD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CO",
            "license": "421",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016003144",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO1322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041009800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "87733",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Wilson
• Jessica Ann Ortega Wilson, DPM
• Joseph Wilson
• Lisett Irina Wilson
• Nicholas Wilson, LCSW
• Ryan M Wilson, PA
• Savannah A. Wilson
• Thomas Charles Wilson, DPM
• Natalia Wiltshire
• Myo Win, MD

• Foot & Ankle Surgery Podiatrist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Foot & Ankle Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.