Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mark Vincent Wilson, MD

Individual provider Orthopaedic Surgery Physician · NPI 1215951579

Mark Vincent Wilson, MD is an Orthopedic Surgery in Johnson City, New York. Graduated from State University of Ny Upstate Medical University in 1999, 27 years ago. Practices with Our Lady of Lourdes Memorial Hospital Inc, a 249-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
27
Trained at
State University of Ny Upstate Medical University
Licensed in
NY
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

240 Riverside Dr
Johnson City, NY 13790-2732
Phone: (607) 798-9356
Fax: (607) 797-1707
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Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence 220358 (NY)

Record details

NPI number1215951579
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 27, 2006
Last updated in NPPESMarch 23, 2021
Certification dateMarch 23, 2021
Mailing address240 Riverside Dr, Johnson City, NY 13790-2732

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolSTATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated 1999 (27 years in practice)
Group practice Our Lady Of Lourdes Memorial Hospital Inc — 249 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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