MICAH JAMES WILSON (NP) – Nurse Practitioner, NPI 1760779904

MICAH JAMES WILSON (NP) is a healthcare provider. based in Ontario, Oregon. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 201150063NP (OR). The NPI Number for MICAH JAMES WILSON (NP) is 1760779904

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
MICAH JAMES WILSON (NP)
NPI
1760779904
Phone
(541) 881-7370
Address
1050 SW 3RD AVE
Enumeration Date
8 July 2011
Last Update Date
8 July 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2512663580
Graduation Year
2011 (15 years ago)
PAC ID
5890965339
Group Practice PAC ID
2062875479
Professional Enrollment ID
I20211104000555
Address ID
AL366083709MO6801XBLVD300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

3,366 NURSE PRACTITIONER in OR

Provider Addresses for MICAH JAMES WILSON (NP)

  • 1050 SW 3RD AVE

    STE 3200

    ONTARIO, OR 979142193

    Phone: (541) 881-7370

    Fax: (541) 881-7379

    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 2 Open Payments records for all available years, with a total value of $36.

Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.

Last reported payment date: 2024-08-27 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($36).

Total Amount

$36

General + Research + Ownership

Payments

2

Total payment records

General Amount

$36

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-27

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2021-11-04

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
I20211104000555INurse PractitionerALTBD

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 97914)

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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: 2062875479View full group profile
NameSpecialtyState
Physician AssistantLA
Cardiovascular Disease (Cardiology), Internal MedicineAL
Family PracticeMS
Internal MedicineAL
H O S P I T A L I S TIN
Internal MedicineVA
Physician AssistantGA
Internal MedicineAL
Nurse PractitionerAL
Internal MedicineME

Reviews

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Frequently asked questions

How do payers reference MICAH JAMES WILSON (NP)?
For MICAH JAMES WILSON (NP), use NPI 1760779904 as the unique 10-digit identifier.
Active or inactive — what applies to MICAH JAMES WILSON (NP)?
You should see MICAH JAMES WILSON (NP) as active in CMS-hosted NPPES data.
How would a patient describe MICAH JAMES WILSON (NP)'s focus?
For MICAH JAMES WILSON (NP), the primary taxonomy reads as Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is MICAH JAMES WILSON (NP) located near Ontario?
MICAH JAMES WILSON (NP) currently maps to Ontario, Oregon in this extract.
Does MICAH JAMES WILSON (NP) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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