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DR. KRISTEN JOHANNA MARY WILS MD
NPI 1023802022
Student in an Organized Health Care Education/Training Program in Portland, CT

Active since April 07, 2025PECOS Enrolled
13 HIGH ST, PORTLAND, CT 06480(860) 358-6418 Get Directions Write a Review

NPPES record last updated: May 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 28, 2025, Apr 7, 2025 (2 updates tracked since 2025).

About Dr. Kristen Johanna Mary Wils Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KRISTEN JOHANNA MARY WILS MD (NPI 1023802022) is an individual student in an organized health care education/training program in Portland, Connecticut and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1023802022
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. KRISTEN JOHANNA MARY WILSCredential: MD
Location Address13 HIGH STPortland, CT 06480-1616
Mailing Address28 Crescent StMiddletown, CT 06457-3654 · (860) 358-6418
Phone(860) 358-6418
Sole ProprietorNo
Enumeration DateApril 7, 2025
Last NPPES UpdateMay 28, 20252 updates tracked since enumeration
NPPES CertifiedMay 28, 2025
✔ NPI 1023802022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
13 HIGH ST, Portland, CT 06480
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Secondary Practice Locations 2

Location 142 E High St Ste 205East Hampton, CT 06424-1056 · Phone (860) 358-6418
Location 290 S Main StMiddletown, CT 06457-3649 · Phone (860) 358-6418

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kristen Johanna Mary Wils Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YADIRA E. ACEVEDO MD
Family Medicine
13 HIGH ST
PORTLAND, CT 06480
Lower Connecticut River Valley Planning Region (860) 358-7100
DR. EVAN TONER-CAO MD
Student in an Organized Health Care Education/Training Program
13 HIGH ST
PORTLAND, CT 06480
Lower Connecticut River Valley Planning Region (860) 358-6418

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kristen Wils's NPI number?

The NPI number for Kristen Wils is 1023802022. It was assigned to this individual provider in the NPPES registry on April 7, 2025.

Where is Kristen Wils located?

Kristen Wils practices at 13 High St, Portland, CT 06480. The listed phone number is (860) 358-6418.

What is Kristen Wils's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kristen Wils enrolled in Medicare?

Yes. Kristen Wils is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kristen Wils was last updated on May 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.