Craig Jeffrey Wilson, MD is a medicare enrolled "Hospitalist" physician in Lebanon, Indiana. His current practice location is
2605 N Lebanon St, Lebanon, Indiana. You can reach out to his office (for appointments etc.) via phone at
(765) 485-8000.
Craig Jeffrey Wilson is licensed to practice in Indiana (license number 01048372A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1407830318.
Physician's Profile
| Full Name | Craig Jeffrey Wilson |
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| Gender | Male |
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| Speciality | Hospitalist |
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| Location | 2605 N Lebanon St, Lebanon, Indiana |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1407830318
- Provider Enumeration Date: 12/05/2005
- Last Update Date: 10/11/2023
Medicare PECOS Information:
- PECOS PAC ID: 8820129331
- Enrollment ID: I20110415000241
Medical Identifiers
Medical identifiers for Craig Jeffrey Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1407830318 | NPI | - | NPPES |
| 200195130 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207R00000X | Internal Medicine | 01048372A (Indiana) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | 01048372A (Indiana) | Secondary |
| 208M00000X | Hospitalist | 01048372A (Indiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Craig Jeffrey Wilson allows following entities to bill medicare on his behalf.
| Entity Name | Witham Memorial Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1083750293 PECOS PAC ID: 4082523170 Enrollment ID: O20040519001402 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Craig Jeffrey Wilson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Craig Jeffrey Wilson, MD 2605 N Lebanon St, Lebanon, IN 46052-1476 Ph: () - | Craig Jeffrey Wilson, MD 2605 N Lebanon St, Lebanon, IN 46052-1476 Ph: (765) 485-8000 |
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