KELLEY WISE – Family Medicine Physician, NPI 1023656600
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for KELLEY WISE
3384 4TH ST
ELKTON, FL 320332232
Phone: (904) 439-3350
Type: Mailing
9 PINE CONE DR STE 102
PALM COAST, FL 321378683
Phone: (386) 445-6191
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 132 Open Payments records for all available years, with a total value of $2,243.
Total Amount is formed as General ($2,243) + Research ($0) + Ownership ($0) = $2,243.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: ABBVIE INC. ($649).
Total Amount
$2,243
General + Research + Ownership
Payments
132
Total payment records
General Amount
$2,243
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $649 |
| GlaxoSmithKline, LLC. | $502 |
| Novo Nordisk Inc | $157 |
| Lilly USA, LLC | $89 |
| Merck Sharp & Dohme LLC | $87 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-02-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200207000535 | I | Nurse Practitioner | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 764 | 456 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 495 | 392 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 210 | 210 | $0 |
| G0444 | Annual depression screening, 5 to 15 minutes | 210 | 210 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 136 | 136 | $0 |
Insurance plans in this area (ZIP 32033)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | MS |
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