Mr Paul Wilson, NP is a medicare enrolled "Nurse Practitioner - Family" in Port Hueneme, California. His current practice location is
162 1st St, Port Hueneme, California. You can reach out to his office (for appointments etc.) via phone at
(805) 982-6362.
Mr Paul Wilson is licensed to practice in California (license number 12242) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1063443984.
Provider's Profile
| Full Name | Mr Paul Wilson |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Family |
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| Location | 162 1st St, Port Hueneme, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1063443984
- Provider Enumeration Date: 07/06/2006
- Last Update Date: 09/26/2023
Medicare PECOS Information:
- PECOS PAC ID: 6507992831
- Enrollment ID: I20100325001052
Medical Identifiers
Medical identifiers for Mr Paul Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1063443984 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 12242 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Paul Wilson allows following entities to bill medicare on his behalf.
| Entity Name | Cabrillo Cardiology Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1518930270
PECOS PAC ID: 5890693279
Enrollment ID: O20031222000943 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Paul Wilson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mr Paul Wilson, NP
162 1st St,
Port Hueneme, CA 93043-4316
Ph: (805) 982-6362 | Mr Paul Wilson, NP
162 1st St,
Port Hueneme, CA 93043-8400
Ph: (805) 982-6362 |
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