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

Active since March 25, 2021PECOS Enrolled

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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

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
Open in Google Maps ↗

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. 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.

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.

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 2 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.