JEROME LAURENCE WILSON (PA-C) – Surgical Physician Assistant, NPI 1588765010
Surgical Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
2,499 PHYSICIAN ASSISTANT in IN
Provider Addresses for JEROME LAURENCE WILSON (PA-C)
1420 CANTERBURY CT
DYER, IN 463112046
Phone: (773) 354-8990
Type: Mailing
2605 Lincoln Hwy
Suite 121
Olympia Fields, IL 604611846
Phone: (773) 354-8990
Type: Location
2650 RIDGE AVE
EVANSTON, IL 602011700
Phone:
Type: Mailing
9650 GROSS POINT RD
SKOKIE, IL 600765080
Phone: (847) 676-1112
Type: Location
1910, Michigan Box Company, Detroit, Wayne County, Michigan, 48211, United States
DETROIT, MI 482781076
Phone: (317) 528-4800
Fax: (317) 865-1479
Type: Mailing
101, Dyer Road, Dover-Foxcroft, Piscataquis County, Maine, 04426, United States
DYER, IN 463113717
Phone: (219) 836-7531
Fax: (219) 836-7593
Type: Location
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 $218.
Total Amount is formed as General ($218) + Research ($0) + Ownership ($0) = $218.
Last reported payment date: 2024-11-06 • Largest payer in this snapshot: Teleflex LLC ($138).
Total Amount
$218
General + Research + Ownership
Payments
5
Total payment records
General Amount
$218
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Teleflex LLC | $138 |
| Boston Scientific Corporation | $25 |
| Astellas Pharma US Inc | $21 |
| Antares Pharma, Inc. | $20 |
| Myriad Genetic Laboratories, Inc. | $14 |
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: 2025-07-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20061108000277 | I | Physician Assistant | IL | TBD |
| I20250703004090 | I | Urology | IN | 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 |
|---|---|---|---|---|
| 51798 | Ultrasound measurement of bladder capacity after voiding | 67 | 62 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 67 | 58 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 53 | 46 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 40 | 40 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 18 | 18 | $0 |
Insurance plans in this area (ZIP 46311)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| E N D O C R I N O L O G Y | IL | |
| N E U R O L O G Y | IL | |
| Hospitalist, Internal Medicine | IL | |
| O P H T H A L M O L O G Y | IL | |
| - | IL | |
| E N D O C R I N O L O G Y | IL | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | IL | |
| Clinical Social Worker | IL | |
| Certified Nurse Midwife (Cnm) | IL |
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