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SHAUN MARIE TANIKA WILSON PAC
NPI 1902140593
Student in an Organized Health Care Education/Training Program in Brooklyn, NY

Active since November 20, 2012PECOS Enrolled
450 CLARKSON AVE, BROOKLYN, NY 11203(718) 270-1000 Get Directions Write a Review

NPPES record last updated: July 2, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shaun Marie Tanika Wilson Pac NPPES

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

SHAUN MARIE TANIKA WILSON PAC (NPI 1902140593) is an individual student in an organized health care education/training program in Brooklyn, New York and active in the NPI registry since November 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902140593
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameSHAUN MARIE TANIKA WILSONCredential: PAC
Location Address450 CLARKSON AVEBrooklyn, NY 11203-2012
Mailing Address1361 E 56th St Apt 2Brooklyn, NY 11234-3374 · (347) 866-7357
Phone(718) 270-1000
Sole ProprietorNo
Enumeration DateNovember 20, 2012
Last NPPES UpdateJuly 2, 2026
NPPES CertifiedJuly 2, 2026
✔ NPI 1902140593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
450 CLARKSON AVE, Brooklyn, NY 11203
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shaun Marie Tanika Wilson Pac 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.

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.

SUNY DOWNSTATE MEDICAL CENTER UHB
Obstetrics & Gynecology
450 CLARKSON AVE
BROOKLYN, NY 11203
Kings County (718) 363-2908
UNIVERSITY PHYSICIANS OF BROOKLYN
Internal Medicine (Gastroenterology)
450 CLARKSON AVE, SUITE A
BROOKLYN, NY 11203
Kings County (718) 270-1112
SNEHALATA R TOPGI MD
Emergency Medicine
450 CLARKSON AVE
BROOKLYN, NY 11203
Kings County (718) 270-3295
DR. MARYAM NOORI KOLOORI M.D.
Student in an Organized Health Care Education/Training Program
450 CLARKSON AVE, SUNY DOWNSTATE MEDICAL CENTER
BROOKLYN, NY 11203
Kings County (412) 737-3789
DR. VIVEK YADAV MD
Internal Medicine (Pulmonary Disease)
450 CLARKSON AVE
BROOKLYN, NY 11203
Kings County (718) 270-3302
DR. DANIEL BEEGAN MD
Family Medicine
450 CLARKSON AVE, MSC 67
BROOKLYN, NY 11203
Kings County (718) 270-4096
ELIEZER LEVITANSKY DO
Emergency Medicine
450 CLARKSON AVE
BROOKLYN, NY 11203
Kings County (245) 331-8718
MIGUEL ANGEL BARRIOS MD
Emergency Medicine
450 CLARKSON AVE
BROOKLYN, NY 11203
Kings County (718) 245-4798

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 Shaun Marie Wilson's NPI number?

The NPI number for Shaun Marie Wilson is 1902140593. It was assigned to this individual provider in the NPPES registry on November 20, 2012.

Where is Shaun Marie Wilson located?

Shaun Marie Wilson practices at 450 Clarkson Ave, Brooklyn, NY 11203. The listed phone number is (718) 270-1000.

What is Shaun Marie Wilson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Shaun Marie Wilson enrolled in Medicare?

Yes. Shaun Marie Wilson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shaun Marie Wilson was last updated on July 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 33 days 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.