KENNETH WILSON – Trauma Surgery Physician, NPI 1902871742
Trauma Surgery Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,444 GENERAL SURGERY in MI
Provider Addresses for KENNETH WILSON
ONE HURLEY PLAZA
FLINT, MI 48503
Phone: (810) 262-7300
Fax: (810) 262-7243
Type: Location
150 HARVESTER DR
SUITE 300
BURR RIDGE, IL 605275919
Phone:
Type: Mailing
5841 S MARYLAND AVE
CHICAGO, IL 606371443
Phone: (888) 824-0200
Type: Location
2388, Midvale Circle, Tucker, DeKalb County, Georgia, 30084, United States
TUCKER, GA 300844219
Phone: (404) 616-1415
Fax: (404) 616-1417
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $2,167.
Total Amount is formed as General ($2,167) + Research ($0) + Ownership ($0) = $2,167.
Last reported payment date: 2024-09-27 • Largest payer in this snapshot: CSL Behring ($1,734).
Total Amount
$2,167
General + Research + Ownership
Payments
10
Total payment records
General Amount
$2,167
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| CSL Behring | $1,734 |
| Kerecis Limited | $418 |
| Ethicon US, LLC | $16 |
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: 2017-10-02
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 |
|---|---|---|---|---|
| I20171002001021 | I | General Surgery | IL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48503)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | IL | |
| N E U R O L O G Y | IL | |
| General Surgery | IN | |
| Pediatric Medicine, Emergency Medicine | IL | |
| - | IL | |
| - | IL | |
| Cardiovascular Disease (Cardiology) | IL | |
| - | IL | |
| Nurse Practitioner | MI | |
| Interventional Cardiology, Internal Medicine, Cardiovascular Disease (Cardiology) | IL |
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