DR. NICOLE MARIE WILSON MD, PHD
NPI 1154908101
Radiology - Diagnostic Radiology in Boston, MA

Q: What is Nicole Wilson's NPI number?

The NPI number for Nicole Wilson is 1154908101. It was assigned to this individual provider in the NPPES registry on March 25, 2021.

Q: What is Nicole Wilson's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Wilson was last updated on June 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since March 25, 2021PECOS Enrolled

55 FRUIT ST, BOSTON, MA 02114(617) 726-2000 Get Directions Write a Review

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 4, 2026, Mar 25, 2021 (2 updates tracked since 2021).

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About Dr. Nicole Marie Wilson Md, Phd NPPES

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

DR. NICOLE MARIE WILSON MD, PHD (NPI 1154908101) is an individual diagnostic radiology provider in Boston, Massachusetts, licensed in Massachusetts (1026219) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Florida International Univ, College Of Medicine (2021).

NPPES Registry Identity

NPI1154908101

Entity TypeIndividualFemale

Primary Taxonomy2085R0202X

Provider Legal NameDR. NICOLE MARIE WILSONCredential: MD, PHD

Location Address55 FRUIT STBoston, MA 02114-2696

Mailing Address55 Fruit StBoston, MA 02114-2696

Phone(617) 726-2000

Sole ProprietorNo

Medical School CMSFlorida International Univ, College Of MedicineGraduated 2021

Enumeration DateMarch 25, 2021

Last NPPES UpdateJune 4, 20262 updates tracked since enumeration

NPPES CertifiedJune 4, 2026

✔ NPI 1154908101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

License✔ Licensed in MA · 1026219

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

55 FRUIT ST, Boston, MA 02114

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicole Marie Wilson Md, Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1557762416

PECOS Enrollment IDI20260526000021

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 Nicole Wilson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Massachusetts General Physicians Organization Inc

Same address

Dermatology

55 FRUIT ST, BUL 2
Boston, MA 02114

Reassigned Medicare billing, Massachusetts enrollment
6,360 clinicians in this Medicare group

NPI 1801874573 (617) 724-0287

The General Hospital Corporation

Same address

General Acute Care Hospital

55 FRUIT ST, BULFINCH 360
Boston, MA 02114

Reassigned Medicare billing, Massachusetts enrollment
6,234 clinicians in this Medicare group

NPI 1023049236 (617) 726-2000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02114 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

$97.64 typical visit price

range $63.72 – $189.86

Typical copayment $24.41 (range $15.93 – $47.46)

Most-billed visit code 99203

Established Patient

$78.84 typical visit price

range $21.07 – $155.29

Typical copayment $19.71 (range $5.26 – $38.82)

Most-billed visit code 99213

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

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.

STUTI GIRISH SHROFF MD, MBBS

Pathology (Anatomic Pathology)

55 FRUIT ST
BOSTON, MA 02114

Suffolk County (617) 726-2971

NANCY WANG M.D.

Internal Medicine (Hematology & Oncology)

55 FRUIT ST
BOSTON, MA 02114

Suffolk County (017) 724-4000

DR. DUSAN HANIDZIAR M.D., PH.D.

Anesthesiology

55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114

Suffolk County (617) 726-3030

JOHN JOSEPH DANKO DO

Physical Medicine & Rehabilitation

55 FRUIT ST
BOSTON, MA 02114

Suffolk County (617) 726-2000

DR. MICHAEL ANDREW LOBRITZ M.D, PH.D.

Internal Medicine (Infectious Disease)

55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114

Suffolk County (617) 724-9248

MS. KELLY ELISHA TRECARTIN NP

Nurse Practitioner (Acute Care)

55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114

Suffolk County (617) 726-7400

JAMIE MARIE ALLEN NP

Nurse Practitioner

55 FRUIT ST
BOSTON, MA 02114

Suffolk County (617) 724-4410

DR. DHAVAL SANJEEV KOLTE M.B.B.S., PH.D.

Internal Medicine (Cardiovascular Disease)

55 FRUIT ST
BOSTON, MA 02114

Suffolk County (617) 643-3238

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 Nicole Wilson's NPI number?

The NPI number for Nicole Wilson is 1154908101. It was assigned to this individual provider in the NPPES registry on March 25, 2021.

Where is Nicole Wilson located?

Nicole Wilson practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 726-2000.

What is Nicole Wilson's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Nicole Wilson enrolled in Medicare?

Yes. Nicole Wilson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Nicole Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Wilson reassigns Medicare benefits to 2 organizations: Massachusetts General Physicians Organization Inc (Boston, MA) and The General Hospital Corporation (Boston, MA). 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 Nicole Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicole Wilson was last updated on June 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.