PO EL WENRICK (PA) – Surgical Physician Assistant, NPI 1083107718
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for PO EL WENRICK (PA)
60 CHASTAIN CENTER BLVD NW STE 66
KENNESAW, GA 301445598
Phone: (770) 423-0595
Fax: (678) 391-5055
Type: Mailing
100, Stone Bridge Parkway, Woodstock, Cherokee County, Georgia, 30101, United States
WOODSTOCK, GA 301898282
Phone: (678) 388-1610
Fax: (678) 388-1628
Type: Mailing
61 WHITCHER ST NE STE 2100
MARIETTA, GA 300601179
Phone: (770) 423-0595
Fax: (678) 391-5055
Type: Location
100 STONEFOREST DR STE 130
WOODSTOCK, GA 301894881
Phone: (678) 388-1621
Fax: (678) 388-1627
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 21 Open Payments records for all available years, with a total value of $750.
Total Amount is formed as General ($750) + Research ($0) + Ownership ($0) = $750.
Last reported payment date: 2024-11-08 • Largest payer in this snapshot: W. L. Gore & Associates, Inc. ($327).
Total Amount
$750
General + Research + Ownership
Payments
21
Total payment records
General Amount
$750
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| W. L. Gore & Associates, Inc. | $327 |
| Silk Road Medical, Inc. | $164 |
| Medtronic, Inc. | $82 |
| ATRICURE, INC. | $53 |
| LeMaitre Vascular, Inc. | $28 |
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: 2018-10-25
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20181025002560 | I | Physician Assistant | GA | 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 |
|---|---|---|---|---|
| 77001 | Fluoroscopic guidance for insertion or removal of central vein access device | 21 | 21 | $0 |
| 36558 | Insertion of tunneled central venous tube for infusion (5 years or older) | 17 | 17 | $0 |
| 35301 | Removal of blood clot and portion of chest, neck, or brain artery | 16 | 16 | $0 |
| 99152 | Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes | 13 | 13 | $0 |
| 36556 | Insertion of non-tunneled central venous tube for infusion (5 years or older) | 11 | 11 | $0 |
Insurance plans in this area (ZIP 30144)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | GA | |
| Nurse Practitioner | GA | |
| Vascular Surgery | TN | |
| Vascular Surgery, General Surgery | GA | |
| Physician Assistant | GA | |
| Nurse Practitioner | GA | |
| Vascular Surgery, Undersea And Hyperbaric Medicine | GA | |
| Nurse Practitioner | GA | |
| Vascular Surgery | GA | |
| Physician Assistant | MS |
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