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CONNOR KEITH WILSON MD, MPH
NPI 1891369906
Emergency Medicine in Providence, RI

Active since May 14, 2021PECOS Enrolled
593 EDDY ST, PROVIDENCE, RI 02903(401) 444-6489 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 11, 2025, May 14, 2021 (2 updates tracked since 2021).

About Connor Keith Wilson Md, Mph NPPES

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

CONNOR KEITH WILSON MD, MPH (NPI 1891369906) is an individual emergency medicine provider in Providence, Rhode Island, licensed in Massachusetts (1022809) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS, is affiliated with Saint Anne's Hospital, and is a graduate of University Of Arkansas College Of Medicine (2021).

NPPES Registry Identity

NPI1891369906
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameCONNOR KEITH WILSONCredential: MD, MPH
Location Address593 EDDY STProvidence, RI 02903-4923
Mailing Address593 Eddy StProvidence, RI 02903-4923
Phone(401) 444-6489
Sole ProprietorNo
Medical School CMSUniversity Of Arkansas College Of MedicineGraduated 2021
Enumeration DateMay 14, 2021
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 11, 2025
✔ NPI 1891369906 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in MA · 1022809
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License LP05312 (RI)

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Connor Keith Wilson Md, Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID143639401
PECOS Enrollment IDI20250613001590
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 Connor Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lifespan Physician Group Of Massachusetts Inc
Family Medicine
2007 BAY ST
Taunton, MA 02780
  • Reassigned Medicare billing, Massachusetts enrollment
  • 547 clinicians in this Medicare group
NPI 1235957713 (774) 409-2009

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

Hospital Affiliations CMS Care Compare

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

Saint Anne's Hospital

Acute Care Hospitals · Fall River, MA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number220020
Location795 Middle StreetFall River, MA 02721 · Bristol County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02903 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
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$103.10 typical visit price
range $18.92 – $144.38
Typical copayment $25.77 (range $4.73 – $36.09)
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. KEITH-AUSTIN SCARFO D.O.
Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Providence County (401) 444-3777
AILEEN HSUEH
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-8450
RHODE ISLAND HOSPITAL
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Providence County (401) 444-7585
DR. GA HIE NAM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-5057
EUGENIE ATALLAH
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-2645
BRET CAULFIELD
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4000
JUNG HO GONG
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 793-2695
FANNY HUANG MD
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4741

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 Connor Wilson's NPI number?

The NPI number for Connor Wilson is 1891369906. It was assigned to this individual provider in the NPPES registry on May 14, 2021.

Where is Connor Wilson located?

Connor Wilson practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 444-6489.

What is Connor Wilson's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Connor Wilson enrolled in Medicare?

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

Which organization bills Medicare for Connor Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Connor Wilson reassigns Medicare benefits to Lifespan Physician Group Of Massachusetts Inc (Taunton, MA). 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 Connor Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Connor Wilson affiliated with any hospitals?

According to CMS data, Connor Wilson is affiliated with Saint Anne's Hospital.

When was this NPI record last updated?

The NPPES record for Connor Wilson was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.