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KEITH D WILSON JR. MD
NPI 1720248198
General Practice in Reisterstown, MD

Active since June 10, 2008PECOS Enrolled
100/100
CMS Quality Rating
11722 REISTERSTOWN RD, REISTERSTOWN, MD 21136(410) 833-5000(410) 833-1433 Get Directions Write a Review

NPPES record last updated: May 31, 2011. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Keith D Wilson Jr. Md NPPES

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

KEITH D WILSON JR. MD (NPI 1720248198) is an individual general practice provider in Reisterstown, Maryland, licensed in Maryland (D71538) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720248198
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameKEITH D WILSON JR.Credential: MD
Location Address11722 REISTERSTOWN RDReisterstown, MD 21136-3302
Mailing AddressPo Box 1708Greenbelt, MD 20768-1708
Phone(410) 833-5000
Fax(410) 833-1433
Sole ProprietorYes
Enumeration DateJune 10, 2008
Last NPPES UpdateMay 31, 2011
✔ NPI 1720248198 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in MD · D71538
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
11722 REISTERSTOWN RD, Reisterstown, MD 21136
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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)

Keith D Wilson Jr. 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 Keith Wilson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Chp MD Medical Affiliates, LLC
4.7 mi
General Practice
7920 MCDONOGH RD STE 101
Owings Mills, MD 21117
  • Reassigned Medicare billing, Maryland enrollment
  • 3 clinicians in this Medicare group
NPI 1326930306 (410) 356-9939
Premier Health LLC
32 mi
Internal Medicine
3202 TOWER OAKS BLVD STE 200
Rockville, MD 20852
  • Reassigned Medicare billing, District of Columbia enrollment
  • 3 clinicians in this Medicare group
NPI 1164951257 (888) 880-3202

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

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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability96
Improvement Activities40

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.

PAULA R LYONS M.D.
Family Medicine
11722 REISTERSTOWN RD
REISTERSTOWN, MD 21136
Baltimore County (410) 833-5000
IMMEDIATE CARE MEDICAL CENTER
Family Medicine
11722 REISTERSTOWN RD
REISTERSTOWN, MD 21136
Baltimore County (410) 833-5000
IMMEDIATE CARE URGENT CARE-REISTERSTOWN, LLC
Clinic/Center (Urgent Care)
11722 REISTERSTOWN RD
REISTERSTOWN, MD 21136
Baltimore County (410) 833-5000

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 Keith Wilson's NPI number?

The NPI number for Keith Wilson is 1720248198. It was assigned to this individual provider in the NPPES registry on June 10, 2008.

Where is Keith Wilson located?

Keith Wilson practices at 11722 Reisterstown Rd, Reisterstown, MD 21136. The listed phone number is (410) 833-5000.

What is Keith Wilson's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Keith Wilson enrolled in Medicare?

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

Which organizations bill Medicare for Keith Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Keith Wilson reassigns Medicare benefits to 2 organizations: Chp MD Medical Affiliates, LLC (Owings Mills, MD) and Premier Health LLC (Rockville, MD). 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 Keith 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 Keith Wilson was last updated on May 31, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.