NICHOLAS ROBERT WILSON MD
NPI 1083177638
Internal Medicine in Saint Paul, MN

Q: What is Nicholas Wilson's NPI number?

The NPI number for Nicholas Wilson is 1083177638. It was assigned to this individual provider in the NPPES registry on April 10, 2019.

Q: What is Nicholas Wilson's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Wilson was last updated on April 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.

Active since April 10, 2019PECOS EnrolledAccepts Medicare Assignment

640 JACKSON ST, SAINT PAUL, MN 55101(651) 254-3456 Get Directions Write a Review

NPPES record last updated: April 20, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 20, 2022, Apr 10, 2019 (2 updates tracked since 2019).

On this page

About Nicholas Robert Wilson Md NPPES

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

NICHOLAS ROBERT WILSON MD (NPI 1083177638) is an individual internal medicine provider in Saint Paul, Minnesota, licensed in Minnesota (70945) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, is affiliated with Park Nicollet Methodist Hospital, and maintains a secondary practice location in Minneapolis.

NPPES Registry Identity

NPI1083177638

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameNICHOLAS ROBERT WILSONCredential: MD

Location Address640 JACKSON STSaint Paul, MN 55101-2502

Mailing Address420 Delaware Street Se, Mmc 284Minneapolis, MN 55455 · (612) 626-5454

Phone(651) 254-3456

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateApril 10, 2019

Last NPPES UpdateApril 20, 20222 updates tracked since enumeration

NPPES CertifiedApril 20, 2022

✔ NPI 1083177638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in MN · 70945

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

640 JACKSON ST, Saint Paul, MN 55101

Open in Google Maps ↗

Secondary Practice Location 1

Location 1420 Delaware Street SE, MMC 284Minneapolis, MN 55455 · Phone (612) 626-5454

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicholas Robert Wilson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9032446117

PECOS Enrollment IDI20220606001766

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.

Medicare Billing Reassignments

Medicare enrollment records show Nicholas Wilson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Group Health, Inc.

1.3 mi

Pediatric Dentistry

205 WABASHA ST S
Saint Paul, MN 55107

Reassigned Medicare billing, Minnesota enrollment
2,274 clinicians in this Medicare group

NPI 1801941943 (651) 227-3757

Park Nicollet Clinic

9.0 mi

Family Medicine

1000 NICOLLET MALL, TPS 260
Minneapolis, MN 55403

Reassigned Medicare billing, Minnesota enrollment
2,527 clinicians in this Medicare group

NPI 1912315144 (952) 977-0700

Hudson Hospital, Inc.

18 mi

Critical Access

405 STAGELINE RD
Hudson, WI 54016

Reassigned Medicare billing, Wisconsin enrollment
Also billed through NPI 1396849303 (Wisconsin)
5 clinicians in this Medicare group

NPI 1255532875 (715) 531-6000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

211 services88 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

61 services61 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

52 services52 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

52 services19 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Park Nicollet Methodist Hospital

Acute Care Hospitals · Saint Louis Park, MN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240053

Location6500 Excelsior BlvdSaint Louis Park, MN 55426 · Hennepin County

Emergency services Birthing friendly

Regions Hospital

Acute Care Hospitals · Saint Paul, MN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240106

Location640 Jackson StreetSaint Paul, MN 55101 · Ramsey County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55101 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$127.61 typical visit price

range $56.00 – $168.28

Typical copayment $31.90 (range $14.00 – $42.07)

Most-billed visit code 99204

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

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

DME-Oxygen and Supplies · category DC002N

3 suppliers19 claims19 services$94.19 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

WOJCIECH KRASZKIEWICZ M.D.

Internal Medicine