PHILLIP ALEX WIMPELBERG (PA) – Medical Physician Assistant, NPI 1871686352

PHILLIP ALEX WIMPELBERG (PA) is a healthcare provider. based in St augustine, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA9101929 (FL). The NPI Number for PHILLIP ALEX WIMPELBERG (PA) is 1871686352

Main info

Male
25 Years Of Experience
Accepts Medicare Assignment
Name
PHILLIP ALEX WIMPELBERG (PA)
NPI
1871686352
Phone
(904) 827-0078
Address
2720 US HIGHWAY 1 S
Enumeration Date
2 October 2006
Last Update Date
31 January 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9045804730
Graduation Year
2001 (25 years ago)
PAC ID
0648231555
Group Practice PAC ID
4688958648
Professional Enrollment ID
I20041025000242
Address ID
FL322566026JA5150XRDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

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Provider Addresses for PHILLIP ALEX WIMPELBERG (PA)

  • South Dixie Highway, West Augustine, Saint Augustine, Saint Johns County, Florida, 32084, United States

    STE B

    ST AUGUSTINE, FL 320866301

    Phone: (904) 827-0078

    Fax: (904) 827-0140

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $34.

Total Amount is formed as General ($34) + Research ($0) + Ownership ($0) = $34.

Last reported payment date: 2024-10-24 • Largest payer in this snapshot: iRhythm Technologies, Inc. ($34).

Total Amount

$34

General + Research + Ownership

Payments

2

Total payment records

General Amount

$34

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-24

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2004-10-25

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20041025000242IPhysician AssistantFLTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32086)

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Provider's Procedures

PHILLIP ALEX WIMPELBERG (PA) performs procedures in PHYSICIAN ASSISTANT. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTFL85610Blood test, clotting time7537

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688958648View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Physician AssistantFL
Nurse PractitionerGA
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

How do payers reference PHILLIP ALEX WIMPELBERG (PA)?
For PHILLIP ALEX WIMPELBERG (PA), use NPI 1871686352 as the unique 10-digit identifier.
Is there an active status for PHILLIP ALEX WIMPELBERG (PA)?
For scheduling context, PHILLIP ALEX WIMPELBERG (PA) is shown as active in the registry.
What area of care is associated with PHILLIP ALEX WIMPELBERG (PA)?
PHILLIP ALEX WIMPELBERG (PA)'s record emphasizes Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with PHILLIP ALEX WIMPELBERG (PA)?
Directory geography for PHILLIP ALEX WIMPELBERG (PA) centers on St Augustine, Florida.
When was this NPI issued?
Enumeration for PHILLIP ALEX WIMPELBERG (PA) is noted as October 2, 2006 where the registry provides it.

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