DOMINIQUE WILSON
NPI 1083369490
Counselor - Professional in Chisago City, MN
About Dominique Wilson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DOMINIQUE WILSON (NPI 1083369490) is an individual professional provider in Chisago City, Minnesota and active in the NPI registry since February 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2010).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
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
Dominique Wilson 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.
Medicare Billing Reassignments
4Medicare enrollment records show Dominique Wilson reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Wyoming, MN 55092
- Reassigned Medicare billing, Minnesota enrollment
- 3,633 clinicians in this Medicare group
Wyoming, MN 55092
- Reassigned Medicare billing, Minnesota enrollment
- 4,038 clinicians in this Medicare group
Vadnais Heights, MN 55127
- Reassigned Medicare billing, Minnesota enrollment
- 2,361 clinicians in this Medicare group
Saint Paul, MN 55104
- Reassigned Medicare billing, Minnesota enrollment
- 2,373 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
CHISAGO CITY, MN 55013
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 Dominique Wilson's NPI number?
The NPI number for Dominique Wilson is 1083369490. It was assigned to this individual provider in the NPPES registry on February 14, 2022.
Where is Dominique Wilson located?
Dominique Wilson practices at 11185 Lake Blvd Ste 205, Chisago City, MN 55013. The listed phone number is (952) 228-3487.
What is Dominique Wilson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Dominique Wilson enrolled in Medicare?
Yes. Dominique Wilson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Dominique Wilson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Dominique Wilson reassigns Medicare benefits to 4 organizations: Fairview Express Care (Wyoming, MN), Fairview Health Services (Wyoming, MN), Healtheast Medical Research Institute (Vadnais Heights, MN) and Fairview Specialty Services (Saint Paul, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dominique Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Dominique Wilson accept?
Health plans from Sanford Health Plan list Dominique Wilson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Dominique Wilson was last updated on February 14, 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.
# Dominique Wilson · NPI 1083369490
Professional provider in Chisago City, Minnesota. Individual provider, active in the CMS NPPES registry since February 14, 2022.
## Identity
- **NPI:** 1083369490 (Entity type: Individual)
- **Enumerated:** February 14, 2022
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 11185 LAKE BLVD STE 205, Chisago City, MN 55013-9814
- **Phone:** (952) 228-3487
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Fairview Express Care (NPI 1346587805, Wyoming, MN); Fairview Health Services (NPI 1083692941, Wyoming, MN); Healtheast Medical Research Institute (NPI 1639125503, Vadnais Heights, MN); Fairview Specialty Services (NPI 1912066218, Saint Paul, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2010
## Record status
- **NPPES last updated:** February 14, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1083369490) · Data from the CMS NPPES public registry.