MITCHELL WILSON (PA-C) – Physician Assistant, NPI 1174030662
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,648 PHYSICIAN ASSISTANT in IA
Provider Addresses for MITCHELL WILSON (PA-C)
450 LAUREL ST STE A
DES MOINES, IA 503143045
Phone: (515) 699-8378
Fax: (515) 248-8888
Type: Mailing
450 Laurel St Ste A
Des Moines, IA 503143045
Phone: (515) 699-8378
Fax: (515) 248-8888
Type: Location
55 COBURG RD
EUGENE, OR 974012433
Phone: (541) 485-8111
Fax: (541) 342-6379
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $527.
Total Amount is formed as General ($527) + Research ($0) + Ownership ($0) = $527.
Last reported payment date: 2024-11-01 • Largest payer in this snapshot: Medical Device Business Services, Inc. ($246).
Total Amount
$527
General + Research + Ownership
Payments
8
Total payment records
General Amount
$527
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-01
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2021-03-17
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 |
|---|---|---|---|---|
| I20210317001441 | I | Physician Assistant | OR | 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 |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 140 | 25 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 140 | 25 | $0 |
| 27447 | Replacement of knee joint, both sides of knee | 67 | 66 | $0 |
| 73562 | X-ray of knee, 3 views | 60 | 53 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 54 | 48 | $0 |
Insurance plans in this area (ZIP 50314)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | OR | |
| Physical Therapist In Private Practice | OR | |
| Orthopedic Surgery | IN | |
| Orthopedic Surgery | OR | |
| Orthopedic Surgery, Hand Surgery | OR | |
| Orthopedic Surgery | OR | |
| Physical Therapist In Private Practice | OR | |
| Physical Therapist In Private Practice | OR | |
| Physician Assistant | OR | |
| Orthopedic Surgery | CA |
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