JERRY DEWAYNE WILSON (PA-C) – Medical Physician Assistant, NPI 1619153210
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,431 PHYSICIAN ASSISTANT in GA
Loading map...
Provider Addresses for JERRY DEWAYNE WILSON (PA-C)
PO BOX 360550
DECATUR, GA 300360550
Phone: (678) 632-4003
Fax: (678) 681-1305
Type: Mailing
4500, Hugh Howell Road, Tucker, DeKalb County, Georgia, 30084, United States
SUITE
TUCKER, GA 300844723
Phone: (678) 632-4003
Fax: (678) 681-1305
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $31.
Total Amount is formed as General ($31) + Research ($0) + Ownership ($0) = $31.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($31).
Total Amount
$31
General + Research + Ownership
Payments
2
Total payment records
General Amount
$31
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $31 |
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: 2004-11-16
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 |
|---|---|---|---|---|
| I20041116000603 | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 155 | 79 | $0 |
Insurance plans in this area (ZIP 30036)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Anesthesiology Assistant | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Internal Medicine, Infectious Disease | GA | |
| - | GA | |
| - | GA | |
| Physician Assistant | GA | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| N E U R O L O G Y | GA |
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.