NICHOLAS RICHARD WILSON PA-C
NPI 1407871262
Physician Assistant - Medical in Temperance, MI

NPI Status: Active since July 13, 2006

Contact Information

8765 LEWIS AVE
TEMPERANCE, MI
ZIP 48182
Phone: (734) 847-3802

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  • Individual
  • Male
  • Years of Experience 28
  • Physician Assistant
  • Medical
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About NICHOLAS WILSON

This page provides the complete NPI Profile along with additional information for Nicholas Wilson, a primary care provider established in Temperance, Michigan with a medical specialization in Physician Assistant, focusing in medical and more than 28 years of experience. The healthcare provider is registered in the NPI registry with number 1407871262 assigned on July 2006. The practitioner's primary taxonomy code is 363AM0700X with license number 5601005306 (MI). The provider is registered as an individual and his NPI record was last updated 11 years ago.

NPI
1407871262
Provider Name
NICHOLAS RICHARD WILSON PA-C
Gender
Male
Entity Type
Individual
Location Address
8765 LEWIS AVE TEMPERANCE, MI 48182
Location Phone
(734) 847-3802
Mailing Address
8765 LEWIS AVE TEMPERANCE, MI 48182
Mailing Phone
(734) 847-3802
Medical School Name
OTHER
Graduation Year
1998
Is Sole Proprietor?
No
Enumeration Date
07-13-2006
Last Update Date
02-26-2014
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A primary care provider (PCP) like Nicholas Wilson sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant Medical

Taxonomy Code
363AM0700X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
5601005306
License State
MI

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Clear Silver - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Bronze First - HMO
  • Bronze First Adult Vision & Fitness - HMO
  • Diabetes Gold - HMO
  • Diabetes Gold Adult Vision & Fitness - HMO
  • Diabetes Silver - HMO
  • Diabetes Silver Adult Vision & Fitness - HMO
  • Gold - HMO
  • Gold Adult Vision & Fitness - HMO
  • HDHP Preventive Silver - HMO
  • Healthy Heart Gold - HMO
  • MHP Bronze - HMO
  • MHP Bronze Saver (Expanded) - HMO
  • MHP Expanded Bronze Standard - HMO
  • MHP Gold - HMO
  • MHP Gold Standard - HMO
  • MHP Silver Exchange - HMO
  • MHP Silver Exchange Rewards - HMO
  • MHP Silver Standard - HMO
  • MHP Young Adult/Catastrophic - HMO
  • MyPriority Balanced Silver - HMO
  • MyPriority Premier Silver - HMO
  • MyPriority Standard Bronze - HMO
  • MyPriority Standard Bronze - Travel - HMO
  • MyPriority Standard Gold - HMO
  • MyPriority Standard Silver - HMO
  • MyPriority Standard Silver - Travel - HMO
  • MyPriority Value Bronze - HMO
  • MyPriority Value Bronze HSA - HMO
  • UHC Bronze Copay Focus (No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Value (No Referrals) - HMO
  • UHC Bronze Value+ (Dental + Vision, No Referrals) - HMO
  • UHC Gold Advantage (No Referrals) - HMO
  • UHC Gold Advantage+ (Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus (No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Silver Advantage (No Referrals) - HMO
  • UHC Silver Advantage+ (Dental + Vision, No Referrals) - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
S87612MEDICARE UPIN (02)IL 

Medicare Participation & PECOS Enrollment Status

Nicholas Wilson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Nicholas Wilson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3779528179

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20140407001902

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    10 DME suppliers used 34 Medicare Claims 53 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    3 DME suppliers used 20 Medicare Claims 20 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    2 DME suppliers used 12 Medicare Claims 12 Services Paid

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Nicholas Wilson is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
PROMEDICA MONROE REGIONAL HOSPITAL718 N MACOMB ST
MONROE, MI 48162
(734) 240-8400Acute Care Hospitals
PROMEDICA TOLEDO HOSPITAL2142 NORTH COVE BOULEVARD
TOLEDO, OH 43606
(419) 291-7482Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1407871262
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
24071672212
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 0 + 7 + 1 + 6 + 7 + 2 + 2 + 1 + 2 + 24 = 58
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 58 = 22

The NPI number 1407871262 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1053399220DR. MARK THOMAS KOEHL M.D.
Individual
Family Medicine8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1912956103MR. EDWARD CHARLES FOLLAS PA-C
Individual
Physician Assistant (Medical)8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1932151206MS. JESSICA M PARSIL MA, LLP
Individual
Counselor (Mental Health)8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1649330648 PATRICIA HELEN BULL M.S.W.
Individual
Social Worker (Clinical)8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1467582197MRS. TERESA KEM GRAHAM CNP
Individual
Nurse Practitioner (Family)8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1043511470MS. LAURIE ANN FRY FNP
Individual
Nurse Practitioner (Family)8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1619241692 AHMED MAHBOOB SYEDA DDS
Individual
Dentist (General Practice)8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1639421035FAMLY MEDICAL CENTER OF MICHIGAN, INC
Organization
Dentist8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1992791453 WILLIAM J DEMOTS MD
Individual
Family Medicine8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1508321118 CHRISTIE BLEVINS
Individual
Dental Hygienist8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 850-6920
1588225338 MARISSA CALLICOTTE PA-C
Individual
Physician Assistant8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 654-2169
1679021240MRS. ERICA KEITH LMSW
Individual
Social Worker (Clinical)8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1972158236MS. RECHAWN A FAIR RDH
Individual
Dental Hygienist8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1265591812FAMILY MEDICAL CENTER OF MICHIGAN,INC
Organization
Clinic/Center (Federally Qualified Health Center (FQHC))8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1346616869 CANDACE KOVAR
Individual
Psychologist (Clinical)8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1104428408 ALEXIS N KUPOVITS-CAVINS LMSW
Individual
Social Worker (Clinical)8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1962078899 WILLIAM BRANTON DDS
Individual
Dentist8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1003586983 HAVERT BEAL II LLPC
Individual
Counselor (Mental Health)8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 850-6900
1407519267FAMILY MEDICAL CENTER OF MICHIGAN, INC
Organization
Clinic/Center (Federally Qualified Health Center (FQHC))8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802
1376267054 MARIAH NIGHSWANDER
Individual
Psychologist (Clinical)8765 LEWIS AVE
TEMPERANCE, MI 48182
(734) 847-3802

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407871262, enumerated in the NPI registry as an "individual" on July 13, 2006

The provider is located at 8765 Lewis Ave Temperance, Mi 48182 and the phone number is (734) 847-3802

The provider's speciality is Physician Assistant with taxonomy code 363AM0700X with a focus in Medical

The provider has more than 28 years of experience.

The provider might be accepting Accepts: Ambetter from Meridian, Ambetter Health, HAP. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The practitioner is affiliated to the following hospital(s): PROMEDICA MONROE REGIONAL HOSPITAL and PROMEDICA TOLEDO HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on July 13, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.