WILEY DOUGLAS III FOWLER (PA-C) – Physician Assistant, NPI 1780936278
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
Provider Addresses for WILEY DOUGLAS III FOWLER (PA-C)
820 PRUDENTIAL DR STE 304
JACKSONVILLE, FL 322078205
Phone: (904) 202-3860
Fax: (904) 202-3846
Type: Location
PO BOX 45443
SALT LAKE CITY, UT 841450443
Phone: (904) 202-1032
Fax: (904) 376-4107
Type: Mailing
1127 16TH AVE S
JACKSONVILLE BEACH, FL 32250
Phone: (904) 247-7778
Type: Location
PO BOX 746638
ATLANTA, GA 303746638
Phone: (904) 202-2092
Fax: (904) 376-4075
Type: Mailing
98 NOCATEE VILLAGE DR
PONTE VEDRA, FL 320816152
Phone: (904) 202-4243
Fax: (904) 390-7415
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $209.
Total Amount is formed as General ($209) + Research ($0) + Ownership ($0) = $209.
Last reported payment date: 2024-09-25 • Largest payer in this snapshot: Eisai Inc. ($152).
Total Amount
$209
General + Research + Ownership
Payments
5
Total payment records
General Amount
$209
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Eisai Inc. | $152 |
| Exact Sciences Corporation | $20 |
| Lilly USA, LLC | $19 |
| Merck Sharp & Dohme LLC | $19 |
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: 2012-11-14
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 |
|---|---|---|---|---|
| I20121114000118 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 1,022 | 114 | $0 |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 461 | 68 | $0 |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 290 | 81 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 142 | 142 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 96 | 82 | $0 |
Insurance plans in this area (ZIP 32207)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Geriatric Medicine, Internal Medicine | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | GA | |
| Internal Medicine, Geriatric Medicine | FL | |
| Nurse Practitioner | GA | |
| Hospitalist, Internal Medicine | FL | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | UT | |
| Hospitalist, Internal Medicine | UT |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.