MATTHEW WILSON – Mental Health Counselor, NPI 1356614150

MATTHEW WILSON is a healthcare provider. based in Melbourne beach, Florida. specializing in MENTAL HEALTH COUNSELOR. The NPI Number for MATTHEW WILSON is 1356614150

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
MATTHEW WILSON
NPI
1356614150
Phone
(407) 361-5788
Address
2187 BARRACUDA AVE
Enumeration Date
10 February 2012
Last Update Date
7 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3212162288
Graduation Year
2011 (15 years ago)
PAC ID
4082122882
Group Practice PAC ID
9335456755
Professional Enrollment ID
I20250804001061
Address ID
FL329013805ME1900XBLVD401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness85
Years active:14State licenses:0Digital endpointsOther names

3,018 MENTAL HEALTH COUNSELOR in FL

Provider Addresses for MATTHEW WILSON

  • 2187 BARRACUDA AVE

    MELBOURNE BEACH, FL 329512909

    Phone: (407) 361-5788

    Type: Mailing

  • 4195 HIELD RD NW

    PALM BAY, FL 329076310

    Phone: (407) 361-5788

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250804001061IMental Health CounselorFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32951)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9335456755View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

How is MATTHEW WILSON identified in CMS data?
CMS-hosted NPPES data lists MATTHEW WILSON with NPI 1356614150.
Does the file indicate MATTHEW WILSON is practicing under active NPI?
Directory data currently reports MATTHEW WILSON as active.
What is MATTHEW WILSON's primary classification?
Mental Health Counselor is the headline specialty for MATTHEW WILSON here. Clinical services aligned with this taxonomy classification.
Does MATTHEW WILSON list a practice location?
Patients near Melbourne Beach, Florida may find MATTHEW WILSON in results; validate coverage separately.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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