MARTY C WILSON (PA-C) – Surgical Physician Assistant, NPI 1184045338

MARTY C WILSON (PA-C) is a healthcare provider. based in Springfield, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 085004959 (IL). The NPI Number for MARTY C WILSON (PA-C) is 1184045338

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
MARTY C WILSON (PA-C)
NPI
1184045338
Phone
(217) 547-9100
Address
1301 S KOKE MILL RD
Enumeration Date
13 December 2013
Last Update Date
13 April 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2175479100
Graduation Year
2013 (13 years ago)
PAC ID
2769611409
Group Practice PAC ID
0143299628
Professional Enrollment ID
I20140129001340
Address ID
IL627119252SP1301XRDXX500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:12State licenses:1Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

Provider Addresses for MARTY C WILSON (PA-C)

  • 1301 S KOKE MILL RD

    SPRINGFIELD, IL 627119252

    Phone: (217) 547-9100

    Fax: (217) 547-9236

    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 5 Open Payments records for all available years, with a total value of $573.

Total Amount is formed as General ($573) + Research ($0) + Ownership ($0) = $573.

Last reported payment date: 2024-11-09 • Largest payer in this snapshot: Zimmer Biomet Holdings, Inc. ($573).

Total Amount

$573

General + Research + Ownership

Payments

5

Total payment records

General Amount

$573

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-09

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: 2014-01-29

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140129001340IPhysician AssistantILTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg1,01287$0
73562X-ray of knee, 3 views250171$0
99213Established patient office or other outpatient visit, 20-29 minutes247198$0
73502X-ray of hip, 2-3 views159118$0
20610Aspiration and/or injection of fluid from large joint13394$0
View full utilization report →

Insurance plans in this area (ZIP 62711)

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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: 0143299628View full group profile
NameSpecialtyState
-IL
-IL
P O D I A T R YWI
Orthopedic SurgeryIL
Physical Medicine And RehabilitationIL
Nurse PractitionerIL
Orthopedic SurgeryMI
Nurse PractitionerIL
-IL
-IL

Reviews

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Frequently asked questions

How do payers reference MARTY C WILSON (PA-C)?
For MARTY C WILSON (PA-C), use NPI 1184045338 as the unique 10-digit identifier.
Is MARTY C WILSON (PA-C) shown as active in public data?
Registry records indicate MARTY C WILSON (PA-C) maintains an active NPI.
How would a patient describe MARTY C WILSON (PA-C)'s focus?
For MARTY C WILSON (PA-C), the primary taxonomy reads as Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with MARTY C WILSON (PA-C)?
Directory geography for MARTY C WILSON (PA-C) centers on Springfield, Illinois.
Does MARTY C WILSON (PA-C) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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