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SETH WILSON M.D.
NPI 1518490754
Family Medicine in Sarasota, FL

Active since April 05, 2017PECOS EnrolledAccepts Medicare Assignment
78.8/100
CMS Quality Rating
5350 UNIVERSITY PKWY STE 101, SARASOTA, FL 34243(941) 917-4675(941) 917-4688 Get Directions Write a Review

NPPES record last updated: June 9, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Seth Wilson M.d. NPPES

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

SETH WILSON M.D. (NPI 1518490754) is an individual family medicine provider in Sarasota, Florida, licensed in Florida (ME143351) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with Sarasota Memorial Hospital, and is a graduate of Wright State University Boonshoft School Of Medicine (2013).

NPPES Registry Identity

NPI1518490754
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameSETH WILSONCredential: M.D.
Location Address5350 UNIVERSITY PKWY STE 101Sarasota, FL 34243-5813
Mailing AddressPo Box 863407Orlando, FL 32886-3407 · (941) 917-2600 · Fax (941) 917-7884
Phone(941) 917-4675
Fax(941) 917-4688
Sole ProprietorYes
Medical School CMSWright State University Boonshoft School Of MedicineGraduated 2013
Enumeration DateApril 5, 2017
Last NPPES UpdateJune 9, 2020
NPPES CertifiedJune 9, 2020
✔ NPI 1518490754 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in FL · ME143351
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.
5350 UNIVERSITY PKWY STE 101, Sarasota, FL 34243
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Oscar Health Maintenance Organization of Florida and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Seth Wilson M.d. 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 ID9335413566
PECOS Enrollment IDI20200626001301
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 Seth Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Smh Physician Services Inc
6.4 mi
Internal Medicine
1700 S TAMIAMI TRL, 1ST FLOOR FPG ADMINISTRATION
Sarasota, FL 34239
  • Reassigned Medicare billing, Florida enrollment
  • 956 clinicians in this Medicare group
NPI 1346295292 (941) 917-8720

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

Areas of Expertise CMS Part B claims 10

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 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.
905 services472 patients
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.
370 services279 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
269 services269 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.
66 services66 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
38 services36 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
37 services27 patients

Hospital Affiliations CMS Care Compare 2

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

Sarasota Memorial Hospital

Acute Care Hospitals · Sarasota, FL
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100087
Location1700 S Tamiami TrlSarasota, FL 34239 · Sarasota County
Emergency services Birthing friendly

Lakewood Ranch Medical Center

Acute Care Hospitals · Bradenton, FL
3/5 CMS rating
OwnershipProprietary
CMS Certification Number100299
Location8330 Lakewood Ranch BlvdBradenton, FL 34202 · Manatee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34243 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.

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.

78.8/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.37
Promoting Interoperability99
Improvement Activities40
Cost50.81

Referred Medical Equipment & Supplies CMS DME claims 3

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

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers24 claims24 services$65.05 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
2 suppliers24 claims24 services$27.61 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier12 claims12 services$185.34 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 3

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

DR. MARIO ANDRES AZUERO M.D.
Family Medicine
5350 UNIVERSITY PKWY STE 101
SARASOTA, FL 34243
Manatee County (941) 917-4675
BRYCE ALLEN SOMER M.D.
Internal Medicine
5350 UNIVERSITY PKWY STE 101
SARASOTA, FL 34243
Manatee County (941) 917-4675
SARASOTA COUNTY PUBLIC HOSPITAL DISTRICT
Clinic/Center (Federally Qualified Health Center (FQHC))
5350 UNIVERSITY PKWY STE 101
SARASOTA, FL 34243
Manatee County (941) 917-4675

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 Seth Wilson's NPI number?

The NPI number for Seth Wilson is 1518490754. It was assigned to this individual provider in the NPPES registry on April 5, 2017.

Where is Seth Wilson located?

Seth Wilson practices at 5350 University Pkwy Ste 101, Sarasota, FL 34243. The listed phone number is (941) 917-4675.

What is Seth Wilson's specialty?

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

Is Seth Wilson enrolled in Medicare?

Yes. Seth 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.

Which organization bills Medicare for Seth Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Seth Wilson reassigns Medicare benefits to Smh Physician Services Inc (Sarasota, FL). 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 Seth Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Seth Wilson accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Oscar Health Maintenance Organization of Florida and UnitedHealthcare list Seth 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.

Is Seth Wilson affiliated with any hospitals?

According to CMS data, Seth Wilson is affiliated with Sarasota Memorial Hospital and Lakewood Ranch Medical Center.

When was this NPI record last updated?

The NPPES record for Seth Wilson was last updated on June 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.