DR. NICOLE APRIL WILSON (PH.D., M.D.) – Pediatric Surgery Physician, NPI 1336588326
Pediatric Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
787 GENERAL SURGERY in MO
Provider Addresses for DR. NICOLE APRIL WILSON (PH.D., M.D.)
1 CHILDRENS PL 5S40
5S40 PEDIATRIC SURGERY
SAINT LOUIS, MO 631101002
Phone: (314) 454-6022
Type: Mailing
1 CHILDRENS PL
SAINT LOUIS, MO 63110
Phone: (314) 454-6022
Type: Location
1200 CHILDRENS AVE STE 2E
OKLAHOMA CITY, OK 731044637
Phone: (405) 271-5789
Fax: (405) 271-1643
Type: Mailing
601 ELMWOOD AVE BOX SURG
ROCHESTER, NY 146420001
Phone: (585) 275-4435
Type: Mailing
601 ELMWOOD AVE BOX SURG BOX SURG
ROCHESTER, NY 146420001
Phone: (585) 275-4435
Fax: (585) 276-2370
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: 2025-09-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200814002695 | I | General Surgery | NY | TBD |
| I20250915001658 | I | General Surgery | OK | TBD |
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.
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 63110)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | OK | |
| O P H T H A L M O L O G Y | OK | |
| Certified Registered Nurse Anesthetist (Crna) | OK | |
| R H E U M A T O L O G Y | OK | |
| Nurse Practitioner | OK | |
| Certified Registered Nurse Anesthetist (Crna) | OK | |
| Certified Registered Nurse Anesthetist (Crna) | OK | |
| Family Practice, Hospitalist | OK | |
| Medical Oncology | RI | |
| Clinical Social Worker | OK |
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