Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1992897490 Individual Practitioner Male Practitioner

Dr. Peter Frederick Wilson , PsyD

Psychologist - Clinical • Gresham, OR

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Peter Wilson, PsyD is a certified Psychologist - Clinical practicing in Gresham, OR. With approximately 28 years of clinical experience since completing medical education in 1998, Dr. Wilson delivers high-quality medical care to the local community at 1217 NE BURNSIDE RD.

Dr. Wilson is affiliated with Cornerstone Clinical Services Pc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include psychotherapy. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1217 Ne Burnside Rd
Bldg B, Suite 401

Gresham, OR 970306722

Telephone 5036668832
Fax 5036698641
Associated Practice Facility / Clinic
🏢 Brian Knight Do Llc Facility NPI 1386630010

Medicare Profile & Education

Medical School

Other

Graduation Year

1998

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Clinical in Gresham, OR

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
28 Yrs +10.2 yrs vs City Avg
City Avg: 17.8 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
13 Specialists

Practicing in Gresham, OR (1193 Statewide)

Telehealth Adoption Rate
30.8% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
40.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wilson (28 Years) 28 Yrs
Gresham Specialty Average (17.8 Years) 17.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
90834 Psychotherapy, 45 minutes
175 12 $175.37 $104.78

Medical Specialties & State Licenses

Psychologist - Clinical Primary Specialty

NUCC Taxonomy Code: 103TC0700X

State License OR 1467

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
164936 (OR)
Commercial Insurance / Payer ID Personal Medicare #
131734 (OR)

Hospital & Practice Group Affiliations

Cornerstone Clinical Services Pc

6400 Se Lake Rd, Milwaukie, OR 972222185

Phone: 5037861711

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

39 Associated Practitioners
Chelsea Trujillo , LCSW

Social Worker - Clinical

NPI 1013376060

Licensed Clinical Social Worker

Sonny Snyder , QMHP-R

Counselor - Professional

NPI 1013771344

QMHPR

NPI 1063761716

Doctor of Psychology (Psy.D.)

Lindsey Romo , CSWA

Social Worker - Clinical

NPI 1083492292
Timothy Gazdziak , LPC

Counselor - Mental Health

NPI 1083814677

Licensed Professional Counselor

Shayna Carter , MA

Counselor - Professional

NPI 1114172285

Master of Arts

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 1217 NE BURNSIDE RD, BLDG B, SUITE 401, GRESHAM, OR 970306722 (Tel: 5036668832)

📍
Updated Business Mailing Address July 08, 2007

Registered at PO BOX 82819, PORTLAND, OR 972820819 (Tel: 5032335405)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as PETER WILSON, PSY.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (License #1467 in OR)

🟢
Initial NPI Registration & Enumeration September 29, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1992897490
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 29, 2006
Last Update: July 08, 2007
Sole Proprietor: No

Mailing Address

Po Box 82819

Portland, OR 972820819

Phone: 5032335405

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.