BRADFORD MARVIN WILSON (PA) – Physician Assistant, NPI 1396233557
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,031 PHYSICIAN ASSISTANT in MN
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Provider Addresses for BRADFORD MARVIN WILSON (PA)
Essentia Health Saint Mary's Medical Center, 407, East 3rd Street, Duluth, Saint Louis County, Minnesota, 55805, United States
DULUTH, MN 558051950
Phone: (218) 786-8364
Type: Location
1340, Walnut Street, Western Springs, Lyons Township, Cook County, Illinois, 60558, United States
WESTERN SPRINGS, IL 605581359
Phone: (708) 927-5945
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2018-08-03
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 |
|---|---|---|---|---|
| I20180803002051 | I | Physician Assistant | MN | 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 | 29 | 12 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 22 | 18 | $0 |
| 43762 | Replacement of stomach stoma tube | 21 | 13 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 20 | 16 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 55805)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | MT | |
| - | ND | |
| Physician Assistant | MN | |
| Nurse Practitioner | SD | |
| - | MN | |
| Qualified Audiologist | MN | |
| - | MN | |
| - | MN | |
| P A T H O L O G Y | WV | |
| Family Practice | MN |
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