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LACEY KAY WILSON DNP
NPI 1720455660
Nurse Practitioner in Scottsdale, AZ

Active since August 26, 2015PECOS Enrolled
71.93/100
CMS Quality Rating
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259(480) 301-8000 Get Directions Write a Review

NPPES record last updated: October 29, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 1, 2024, Feb 21, 2019 (2 updates tracked since 2019).

About Lacey Kay Wilson Dnp NPPES

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

LACEY KAY WILSON DNP (NPI 1720455660) is an individual nurse practitioner in Scottsdale, Arizona, licensed in Arizona (312886) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Pendleton.

NPPES Registry Identity

NPI1720455660
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameLACEY KAY WILSONCredential: DNP
Location Address13400 E SHEA BLVDScottsdale, AZ 85259-5499
Mailing Address13400 E Shea BlvdScottsdale, AZ 85259-5499 · (480) 301-8000
Phone(480) 301-8000
Sole ProprietorNo
Enumeration DateAugust 26, 2015
Last NPPES UpdateOctober 29, 20242 updates tracked since enumeration
NPPES CertifiedOctober 29, 2024
✔ NPI 1720455660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in AZ · 312886
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 201506113NPPP (OR)
13400 E SHEA BLVD, Scottsdale, AZ 85259
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Secondary Practice Location 1

Location 13001 St Anthony WayPendleton, OR 97801 · Phone (541) 966-0535 · Fax (541) 278-4597

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lacey Kay Wilson Dnp 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 Lacey Wilson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mayo Clinic Arizona
0.1 mi
Multi-Specialty
13400 E SHEA BLVD
Scottsdale, AZ 85259
  • Reassigned Medicare billing, Arizona enrollment
  • 1,792 clinicians in this Medicare group
NPI 1558332494 (480) 301-8000
Mid-Columbia Medical Center
966 mi
Rural Health
1935 E 19TH ST
The Dalles, OR 97058
  • Reassigned Medicare billing, Oregon enrollment
  • 195 clinicians in this Medicare group
NPI 1528383940 (541) 506-6520

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 85259 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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.

71.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality90.53
Promoting Interoperability100
Improvement Activities40
Cost10

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.

AMITKUMAR MEHTA MD
Internal Medicine (Hematology & Oncology)
13400 E SHEA BLVD
SCOTTSDALE, AZ 85259
Maricopa County (480) 301-8000
DR. DEBJIT SAHA MBBS
Internal Medicine (Critical Care Medicine)
13400 E SHEA BLVD
SCOTTSDALE, AZ 85259
Maricopa County (480) 301-8000
MICHAL REID M.D.
Internal Medicine (Pulmonary Disease)
13400 E SHEA BLVD
SCOTTSDALE, AZ 85259
Maricopa County (480) 301-8000
DR. DANIEL MARK FRENDL MD, PHD
Urology
13400 E SHEA BLVD
SCOTTSDALE, AZ 85259
Maricopa County (480) 301-8000
BRETT THEODORE TOLPA CRNA
Nurse Anesthetist, Certified Registered
13400 E SHEA BLVD
SCOTTSDALE, AZ 85259
Maricopa County (480) 301-8000
GINA MUNSON CRNA
Nurse Anesthetist, Certified Registered
13400 E SHEA BLVD
SCOTTSDALE, AZ 85259
Maricopa County (480) 301-8000
DR. CATALINA NICOLE FLORES MD
Radiology (Diagnostic Radiology)
13400 E SHEA BLVD
SCOTTSDALE, AZ 85259
Maricopa County (480) 301-8000
NICOLE WARRINGTON MD
Radiology (Diagnostic Radiology)
13400 E SHEA BLVD
SCOTTSDALE, AZ 85259
Maricopa County (480) 301-8000

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 Lacey Wilson's NPI number?

The NPI number for Lacey Wilson is 1720455660. It was assigned to this individual provider in the NPPES registry on August 26, 2015.

Where is Lacey Wilson located?

Lacey Wilson practices at 13400 E Shea Blvd, Scottsdale, AZ 85259. The listed phone number is (480) 301-8000.

What is Lacey Wilson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Lacey Wilson enrolled in Medicare?

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

Which organizations bill Medicare for Lacey Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lacey Wilson reassigns Medicare benefits to 2 organizations: Mayo Clinic Arizona (Scottsdale, AZ) and Mid-Columbia Medical Center (The Dalles, OR). 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 Lacey Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lacey Wilson accept?

Health plans from Moda Health Plan, Inc. and Providence Health Plan list Lacey 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 Lacey Wilson was last updated on October 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.