BRANDON WILSON PA-C NPI 1285056770

NPI Information

  • NPI: 1285056770
  • Provider Name: BRANDON WILSON, PA-C
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 10475 CENTURION PKWY N STE 220
    JACKSONVILLE, FL
    ZIP 32256
  • Phone: (904) 634-0640

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NPI Details

Brandon Wilson, PA-C is a surgical physician assistant in Jacksonville, FL with 13 years of experience. Brandon Wilson, PA-C NPI is 1285056770. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10475 CENTURION PKWY N STE 220
JACKSONVILLE, FL
ZIP 32256-004
Phone: (904) 634-0640
Fax: (904) 634-0203

The NPI 1285056770 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Replacement of knee joint, both sides of knee (HCPCS:27447)
  • Replacement of thigh bone and hip joint with prosthesis (HCPCS:27130)
  • Prosthetic repair of shoulder joint, total shoulder (HCPCS:23472)
  • Fusion of lower spine bone and partial removal of spine bone or disc through back, 1 disc (HCPCS:22630)
  • Placement of stabilizing device to back of 1 spine bone in neck (HCPCS:22840)

The enumeration date for this NPI number is 1/17/2014 and was last updated on 7/28/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1246ZC0007XSpecialist/Technologist, OtherSurgical AssistantPA9107780FLORIDANo
2363A00000XPhysician AssistantPA9107780FLORIDANo
3363AS0400XPhysician AssistantSurgicalPA9107780FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1122700900MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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