DR. MARK WILSON (MD) – Emergency Medicine Physician, NPI 1679660682
Emergency Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. MARK WILSON (MD)
PO BOX 10821
COLLEGE STATION, TX 778420821
Phone: (352) 672-1417
Type: Mailing
209 NW 8th St
Seminole, TX 793603447
Phone: (432) 758-5811
Type: Location
3134 BRIARCREST DR
BRYAN, TX 778023014
Phone: (979) 314-2323
Type: Location
17268 EAGLE PASS DR
COLLEGE STATION, TX 778454567
Phone: (979) 217-1317
Type: Mailing
CHI Saint Joseph Health Regional Hospital, 2801, Franciscan Drive, Bryan, Brazos County, Texas, 77802, United States
ST. JOSEPH'S REGIONAL HEALTH SYSTEM- EMERGENCY DEPT.
BRYAN, TX 77802
Phone: (352) 672-1417
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: 2008-12-03
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20081203000452 | I | Emergency Medicine | TX | 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 77842)
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