KELBY JON WILSON (MD) – Family Medicine Physician, NPI 1164872115
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
969 FAMILY PRACTICE in ID
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Provider Addresses for KELBY JON WILSON (MD)
Syringa Hospital & Clinics, 607, West Main Street, Grangeville, Idaho County, Idaho, 83530, United States
GRANGEVILLE, ID 835301345
Phone: (208) 983-1700
Fax: (208) 983-4665
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 1 Open Payments records for all available years, with a total value of $21.
Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.
Last reported payment date: 2024-10-15 • Largest payer in this snapshot: Philips North America LLC ($21).
Total Amount
$21
General + Research + Ownership
Payments
1
Total payment records
General Amount
$21
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Philips North America LLC | $21 |
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: 2019-07-29
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 |
|---|---|---|---|---|
| I20190729001812 | I | Family Practice | ID | 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 |
|---|---|---|---|---|
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 38 | 26 | $0 |
Insurance plans in this area (ZIP 83530)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice, Emergency Medicine, Osteopathic Manipulative Medicine, Hospitalist, Family Practice | ID | |
| Family Practice | ID | |
| Nurse Practitioner | ID | |
| Nurse Practitioner | ID | |
| Physician Assistant | ID | |
| - | PA | |
| Nurse Practitioner | ID | |
| - | ID | |
| Emergency Medicine | CA | |
| Family Practice | ID |
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