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CAMILLE WILSON MD
NPI 1669009775
Pediatrics in Hackensack, NJ

Active since March 26, 2020PECOS Enrolled
30 PROSPECT AVE, HACKENSACK, NJ 07601(909) 922-4889 Get Directions Write a Review

NPPES record last updated: May 4, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 4, 2026, Mar 26, 2020 (2 updates tracked since 2020).

About Camille Wilson Md NPPES

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

CAMILLE WILSON MD (NPI 1669009775) is an individual pediatrics provider in Hackensack, New Jersey, licensed in California (A188246) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669009775
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameCAMILLE WILSONCredential: MD
Location Address30 PROSPECT AVEHackensack, NJ 07601-1915
Mailing Address7432 Saintsbury PlRancho Cucamonga, CA 91739-8563 · (909) 922-4889
Phone(909) 922-4889
Sole ProprietorNo
Enumeration DateMarch 26, 2020
Last NPPES UpdateMay 4, 20262 updates tracked since enumeration
NPPES CertifiedMay 4, 2026
✔ NPI 1669009775 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A188246
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.
30 PROSPECT AVE, Hackensack, NJ 07601
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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)

Camille Wilson Md 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 Reassignments

2

Medicare enrollment records show Camille Wilson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southern California Permanente Medical Group
2,388 mi
Health Maintenance Organization
3527 W FLORIDA AVE
Hemet, CA 92545
  • Reassigned Medicare billing, California enrollment
  • 5,228 clinicians in this Medicare group
NPI 1013433465 (877) 608-0044
Children's Hospital Los Angeles Medical Group, Inc.
2,449 mi
Multi-Specialty
4650 SUNSET BLVD
Los Angeles, CA 90027
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Childrens Hospital Los Angeles Medical Group Inc
  • 1,281 clinicians in this Medicare group
NPI 1265530653 (323) 361-2337

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 07601 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
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

DR. JESUS RAFAEL ALVAREZ-PEREZ M.D.
Obstetrics & Gynecology (Maternal & Fetal Medicine)
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (551) 996-2453
JENNIFER NORTHRIDGE M.D.
Pediatrics (Adolescent Medicine)
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (551) 996-2237
ANALYSA GALLEGOS MD
Emergency Medicine
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (551) 996-2331
DR. PAARTH RAJ D.O.
Emergency Medicine
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (201) 996-2000
MRS. LAUREN ANNE CARUCCI NP-C
Nurse Practitioner (Adult Health)
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (551) 996-2000
MS. SOMDATTA GUPTA
Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (973) 216-7796
ALEXANDER SHERMAN DO
Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (818) 635-2802
DR. TYLER MICHAEL CHAFITZ MD, MBA
Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (551) 996-2000

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 Camille Wilson's NPI number?

The NPI number for Camille Wilson is 1669009775. It was assigned to this individual provider in the NPPES registry on March 26, 2020.

Where is Camille Wilson located?

Camille Wilson practices at 30 Prospect Ave, Hackensack, NJ 07601. The listed phone number is (909) 922-4889.

What is Camille Wilson's specialty?

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

Is Camille Wilson enrolled in Medicare?

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

Which organizations bill Medicare for Camille Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Camille Wilson reassigns Medicare benefits to 2 organizations: Southern California Permanente Medical Group (Hemet, CA) and Children's Hospital Los Angeles Medical Group, Inc. (Los Angeles, CA). Each 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 Camille 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 Camille Wilson was last updated on May 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.