Active NPI 1770397853 Individual Practitioner Male Practitioner

Mark Paul Wilson , CRPA PROVISIONAL

Peer Specialist • E Patchogue, NY

Professional Overview & Biography Verified Profile Summary

Mark Wilson, CRPA PROVISIONAL is a registered healthcare professional specializing in Peer Specialist in E Patchogue, NY. Practice services are available at 98 PINE NECK AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

98 Pine Neck Ave

E Patchogue, NY 117725730

Telephone 6319012767

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in E Patchogue, NY

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 10.2 Yrs

Regional Practice Density

1 Specialists

Practicing in E Patchogue, NY (1559 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-02-21

Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active February 08, 2025

NPI status registered as active in NPPES database

📍

Updated Practice Location February 08, 2025

Registered at 98 PINE NECK AVE, E PATCHOGUE, NY 117725730 (Tel: 6319012767)

📍

Updated Business Mailing Address February 08, 2025

Registered at 98 PINE NECK AVE, E PATCHOGUE, NY 117725730 (Tel: 6319012767)

👤

Provider Name / Credentials Updated February 08, 2025

Recorded as MARK WILSON, CRPA PROVISIONAL

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 08, 2025

Student in an Organized Health Care Education/Training Program

🟢

Initial NPI Registration & Enumeration February 06, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

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NPI Administrative Meta

NPI Number: 1770397853

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: February 06, 2025

Last Update: February 21, 2025

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

98 Pine Neck Ave

E Patchogue, NY 117725730

Phone: 6319012767

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.