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ALICIA MARIE WILSON D.O.
NPI 1285070284
Pediatrics in South Bend, IN

Active since May 16, 2013PECOS Enrolled
211 N EDDY ST, SOUTH BEND, IN 46617(574) 233-7337(574) 239-1561 Get Directions Write a Review

NPPES record last updated: June 27, 2016. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Alicia Marie Wilson D.o. NPPES

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

ALICIA MARIE WILSON D.O. (NPI 1285070284) is an individual pediatrics provider in South Bend, Indiana, licensed in Indiana (02004821A) and active in the NPI registry since May 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285070284
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameALICIA MARIE WILSONCredential: D.O.
Location Address211 N EDDY STSouth Bend, IN 46617-3096
Mailing Address211 N Eddy StSouth Bend, IN 46617-3096 · (574) 233-7337 · Fax (574) 239-1561
Phone(574) 233-7337
Fax(574) 239-1561
Sole ProprietorNo
Enumeration DateMay 16, 2013
Last NPPES UpdateJune 27, 2016
✔ NPI 1285070284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IN · 02004821A
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
211 N EDDY ST, South Bend, IN 46617
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Other Names 1

Former Name (1)Alicia Marie Keck

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alicia Marie Wilson D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Alicia Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

The South Bend Clinic, LLC
Same address
Anesthesiology
211 N EDDY ST
South Bend, IN 46617
  • Reassigned Medicare billing, Indiana enrollment
  • 211 clinicians in this Medicare group
NPI 1487307492 (574) 239-1567

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 46617 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

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.

AUTUMN MARIE HANNA PA
Physician Assistant
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 234-8161
DR. STEVEN P. CROWELL MD
Internal Medicine
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 237-9340
JESSICA A HECKMAN R.D.
Dietitian, Registered
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 237-9331
LOUIS CAVADINI DO
Family Medicine
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 237-9395
MS. REGINA R. JASIEWICZ FNP
Nurse Practitioner (Family)
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 237-9231
DR. ERSALAN A RAHMAN M.D.
Ophthalmology
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 237-9334
DR. SCOTT H WOLF MD
Radiology (Diagnostic Radiology)
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 237-9203
MRS. AMY KAY KARANJA NP
Nurse Practitioner (Family)
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 234-8161

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 Alicia Wilson's NPI number?

The NPI number for Alicia Wilson is 1285070284. It was assigned to this individual provider in the NPPES registry on May 16, 2013. The provider is also known as Alicia Marie Keck.

Where is Alicia Wilson located?

Alicia Wilson practices at 211 N Eddy St, South Bend, IN 46617. The listed phone number is (574) 233-7337.

What is Alicia Wilson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Alicia Wilson enrolled in Medicare?

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

Which organization bills Medicare for Alicia Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Alicia Wilson reassigns Medicare benefits to The South Bend Clinic, LLC (South Bend, IN). The 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 Alicia Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Alicia Wilson accept?

Health plans from Anthem Blue Cross and Blue Shield list Alicia 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 Alicia Wilson was last updated on June 27, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.