DR. JACOB THOMAS WILSON MD
NPI 1245960509
Family Medicine in Daytona Beach, FL

Q: What is Jacob Wilson's NPI number?

The NPI number for Jacob Wilson is 1245960509. It was assigned to this individual provider in the NPPES registry on June 10, 2022.

Q: What is Jacob Wilson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Wilson was last updated on November 19, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 10, 2022PECOS EnrolledAccepts Medicare Assignment

201 N CLYDE MORRIS BLVD STE 200, DAYTONA BEACH, FL 32114(386) 425-4165(386) 425-7545 Get Directions Write a Review

NPPES record last updated: November 19, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 19, 2024, Jun 10, 2022 (2 updates tracked since 2022).

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About Dr. Jacob Thomas Wilson Md NPPES

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

DR. JACOB THOMAS WILSON MD (NPI 1245960509) is an individual family medicine provider in Daytona Beach, Florida, licensed in Florida (TRN35827) and active in the NPI registry since June 2022. He is enrolled in Medicare PECOS, is affiliated with Halifax Health Medical Center, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1245960509

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. JACOB THOMAS WILSONCredential: MD

Location Address201 N CLYDE MORRIS BLVD STE 200Daytona Beach, FL 32114-2765

Mailing Address201 N Clyde Morris Blvd Ste 200Daytona Beach, FL 32114-2765 · (386) 425-4165 · Fax (386) 425-7545

Phone(386) 425-4165

Fax(386) 425-7545

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateJune 10, 2022

Last NPPES UpdateNovember 19, 20242 updates tracked since enumeration

NPPES CertifiedNovember 19, 2024

✔ NPI 1245960509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in FL · TRN35827✔ Licensed in FL · ME166148

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

201 N CLYDE MORRIS BLVD STE 200, Daytona Beach, FL 32114

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jacob Thomas 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 ID5890179568

PECOS Enrollment IDI20250724002924

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.

Hospital Affiliations CMS Care Compare 2

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

Halifax Health Medical Center

Acute Care Hospitals · Daytona Beach, FL

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100017

Location303 N Clyde Morris BlvdDaytona Beach, FL 32114 · Volusia County

Emergency services Birthing friendly

Halifax Health /Uf Health Medical Center Of Delton

Acute Care Hospitals · Deltona, FL

OwnershipGovernment - Local

CMS Certification Number100330

Location3300 Halifax Crossings BlvdDeltona, FL 32725 · Volusia County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32114 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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.

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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.

EVANS MARRERO

Family Medicine