NICHOLAS RICHARD WILSON (PA-C) – Medical Physician Assistant, NPI 1407871262

NICHOLAS RICHARD WILSON (PA-C) is a healthcare provider. based in Temperance, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 5601005306 (MI). The NPI Number for NICHOLAS RICHARD WILSON (PA-C) is 1407871262

Main info

Male
28 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLAS RICHARD WILSON (PA-C)
NPI
1407871262
Phone
(734) 847-3802
Address
8765 LEWIS AVE
Enumeration Date
13 July 2006
Last Update Date
26 February 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7346392546
Graduation Year
1998 (28 years ago)
PAC ID
3779528179
Group Practice PAC ID
2769575653
Professional Enrollment ID
I20140407001902
Address ID
MI481623126MO1085XSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

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Provider Addresses for NICHOLAS RICHARD WILSON (PA-C)

  • Family Medical Center of Michigan, 8765, Lewis Avenue, Temperance, Bedford Township, Monroe County, Michigan, 48182, United States

    TEMPERANCE, MI 481829583

    Phone: (734) 847-3802

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $13.

Total Amount is formed as General ($13) + Research ($0) + Ownership ($0) = $13.

Last reported payment date: 2024-07-09 • Largest payer in this snapshot: ABBVIE INC. ($13).

Total Amount

$13

General + Research + Ownership

Payments

1

Total payment records

General Amount

$13

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-09

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$13
View all Open Payments →|Open Payments Risk Radar →

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: 2014-04-07

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
I20140407001902IPhysician AssistantMITBD

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 48182)

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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: 2769575653View full group profile
NameSpecialtyState
Mental Health CounselorMI
-MI
Family PracticeMI
Clinical Social WorkerMI
Nurse PractitionerHI
Clinical Social WorkerMI
Family PracticeOH
Family PracticeOH
Family PracticeMI
Mental Health CounselorMI

Reviews

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Frequently asked questions

What federal number belongs to NICHOLAS RICHARD WILSON (PA-C)?
The federal identifier for NICHOLAS RICHARD WILSON (PA-C) is NPI 1407871262.
Does this profile mean NICHOLAS RICHARD WILSON (PA-C) is currently active?
Yes — NICHOLAS RICHARD WILSON (PA-C) appears active in the national provider directory.
What does NICHOLAS RICHARD WILSON (PA-C) treat or focus on?
Patients typically see NICHOLAS RICHARD WILSON (PA-C) under the specialty Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What location metadata exists for NICHOLAS RICHARD WILSON (PA-C)?
The page summarizes Temperance, Michigan for NICHOLAS RICHARD WILSON (PA-C); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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