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DR. ADAM DEFOREST WILSON PH.D.
NPI 1619756145
Psychologist - Clinical in San Mateo, CA

Active since September 25, 2023PECOS Enrolled
10 BERESFORD CT, SAN MATEO, CA 94403(607) 379-4305 Get Directions Write a Review

NPPES record last updated: September 25, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Adam Deforest Wilson Ph.d. NPPES

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

DR. ADAM DEFOREST WILSON PH.D. (NPI 1619756145) is an individual clinical provider in San Mateo, California, licensed in California (PSY34482) and active in the NPI registry since September 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619756145
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. ADAM DEFOREST WILSONCredential: PH.D.
Location Address10 BERESFORD CTSan Mateo, CA 94403-4597
Mailing Address1201 Milton StPittsburgh, PA 15218-1232
Phone(607) 379-4305
Sole ProprietorYes
Enumeration DateSeptember 25, 2023
NPPES CertifiedSeptember 25, 2023
✔ NPI 1619756145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · PSY34482
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
10 BERESFORD CT, San Mateo, CA 94403
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Adam Deforest Wilson Ph.d. 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 Adam Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group PC
26 mi
Mental Health
99 S ALMADEN BLVD STE 600
San Jose, CA 95113
  • Reassigned Medicare billing, California enrollment
  • 3,139 clinicians in this Medicare group
NPI 1154994846 (408) 402-4385

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 94403 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
$202.35 typical visit price
range $69.00 – $202.35
Typical copayment $50.58 (range $17.25 – $50.58)
Most-billed visit code 99205
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
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.

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 Adam Wilson's NPI number?

The NPI number for Adam Wilson is 1619756145. It was assigned to this individual provider in the NPPES registry on September 25, 2023.

Where is Adam Wilson located?

Adam Wilson practices at 10 Beresford Ct, San Mateo, CA 94403. The listed phone number is (607) 379-4305.

What is Adam Wilson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Adam Wilson enrolled in Medicare?

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

Which organization bills Medicare for Adam Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Adam Wilson reassigns Medicare benefits to Grow Healthcare Group PC (San Jose, CA). 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 Adam Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Adam Wilson was last updated on September 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.