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THOMAS GROVE WILSON CNP
NPI 1316495401
Nurse Practitioner - Primary Care in Maplewood, MN

Active since September 16, 2016PECOS EnrolledAccepts Medicare Assignment
81.72/100
CMS Quality Rating
3100 KENNARD ST, SUITE 100, MAPLEWOOD, MN 55109(651) 232-7800(651) 232-7940 Get Directions Write a Review

NPPES record last updated: September 16, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Thomas Grove Wilson Cnp NPPES

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

THOMAS GROVE WILSON CNP (NPI 1316495401) is an individual primary care provider in Maplewood, Minnesota, licensed in Minnesota (CNP 4710) and active in the NPI registry since September 2016. He is enrolled in Medicare PECOS and is a graduate of University Of North Dakota School Of Medicine (2016).

NPPES Registry Identity

NPI1316495401
Entity TypeIndividualMale
Primary Taxonomy363LP2300X
Provider Legal NameTHOMAS GROVE WILSONCredential: CNP
Location Address3100 KENNARD ST, SUITE 100Maplewood, MN 55109-5465
Mailing Address3100 Kennard St, Suite 100Maplewood, MN 55109-5465 · (651) 232-7800 · Fax (651) 232-7940
Phone(651) 232-7800
Fax(651) 232-7940
Sole ProprietorNo
Medical School CMSUniversity Of North Dakota School Of MedicineGraduated 2016
Enumeration DateSeptember 16, 2016
✔ NPI 1316495401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in MN · CNP 4710
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License CNP 4710 (MN)
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License CNP 4710 (MN)
3100 KENNARD ST, Maplewood, MN 55109
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Sanford Health Plan.Insurance ›

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

Thomas Grove Wilson Cnp 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 ID4284916727
PECOS Enrollment IDI20170118002240
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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
67 services65 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
34 services31 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
26 services26 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
14 services14 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55109 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.72/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.86
Promoting Interoperability100
Improvement Activities40
Cost59.73

Referred Medical Equipment & Supplies CMS DME claims 14

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
13 suppliers58 claims58 services$34.65 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
7 suppliers24 claims24 services$74.52 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
5 suppliers15 claims27 services$29.10 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
5 suppliers12 claims37 services$13.60 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
6 suppliers15 claims53 services$13.13 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
10 suppliers40 claims40 services$43.57 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KARIN E DETIENNE
Licensed Practical Nurse
3100 KENNARD ST
MAPLEWOOD, MN 55109
Ramsey County (651) 225-5447
MRS. ALYSSA RAE WILLIAMS LPN
Licensed Practical Nurse
3100 KENNARD ST
MAPLEWOOD, MN 55109
Ramsey County (651) 225-5420
HAVONA MOORE
Licensed Practical Nurse
3100 KENNARD ST
MAPLEWOOD, MN 55109
Ramsey County (651) 225-5456
ANGELA ROESER LPN
Licensed Practical Nurse
3100 KENNARD ST
MAPLEWOOD, MN 55109
Ramsey County (651) 747-4652
MORGAN MCKINLEY
Licensed Practical Nurse
3100 KENNARD ST
MAPLEWOOD, MN 55109
Ramsey County (651) 225-5420
GEORGIANN MARIE MELTON PSYCHOTHERAPIST
Counselor (Addiction (Substance Use Disorder))
3100 KENNARD ST
MAPLEWOOD, MN 55109
Ramsey County (612) 356-4634
DR. KENT DAVIS BERGH M.D.
Family Medicine
3100 KENNARD ST, SUITE 100 HEALTHEAST PHYSICIAN SERVICE,
MAPLEWOOD, MN 55109
Ramsey County (651) 232-7800
CHRISTOPHER NEVILLE USSHER M.D.
Internal Medicine (Rheumatology)
3100 KENNARD ST
MAPLEWOOD, MN 55109
Ramsey County (650) 737-2692

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 Thomas Wilson's NPI number?

The NPI number for Thomas Wilson is 1316495401. It was assigned to this individual provider in the NPPES registry on September 16, 2016.

Where is Thomas Wilson located?

Thomas Wilson practices at 3100 Kennard St Suite 100, Maplewood, MN 55109. The listed phone number is (651) 232-7800.

What is Thomas Wilson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Thomas Wilson enrolled in Medicare?

Yes. Thomas 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.

What insurance does Thomas Wilson accept?

Health plans from Medica and Sanford Health Plan list Thomas 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 Thomas Wilson was last updated on September 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.