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Matthew David Wilson

Hospitalist

Allopathic & Osteopathic Physicians

3901 Rainbow Blvd. 6040 Delp, Ms 1020, Division Of General And Geriatric Medicine, Kansas City, KS 66160-0001

PECOS Enrollment

This provider is enrolled in PECOS as MATTHEW WILSON.

Based on the most recent information from CMS, provider Matthew David Wilson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1114346681
Provider Type
Individual
Full Name
Wilson, Matthew David
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
4/14/2014
Last Updated
7/21/2022

Contact Information

Practice Location

3901 Rainbow Blvd. 6040 Delp, Ms 1020, Division Of General And Geriatric Medicine, Kansas City, KS 66160-0001

(913) 588-6005

(913) 588-3877

Mailing Location

3901 Rainbow Blvd. 4070 Delp, Ms 4017, Kansas University Physicians, Inc., Kansas City, KS 66160-0001

(913) 588-2501

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208M00000X Primary	Description Hospitalist Allopathic & Osteopathic Physicians	License 0440000 Kansas
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer Tennessee

Matthew David Wilson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Opole, Isaac O

Molenda, Bridgette N

Howe, Erica E

Girard, Jennifer Loso

Moudgal, Anita N

Graham, Ian F

Mishra, Abhay

Diebolt, Leah M

Bhakta, Maharshi

Khan, Muhammad Atif