LEVI SAMUEL WIDENER – Physician Assistant, NPI 1306512371
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in VA
Provider Addresses for LEVI SAMUEL WIDENER
1021 W OAKLAND AVE STE 310
JOHNSON CITY, TN 376042192
Phone: (423) 952-2111
Type: Mailing
245 MEDICAL PARK DR STE B
MARION, VA 24354
Phone: (276) 378-3020
Type: Location
21371 Forsythe Rd
Bristol, VA 242024357
Phone: (276) 525-4377
Type: Location
16000 Johnston Memorial Dr
Abingdon, VA 24211
Phone: (276) 258-1000
Type: Location
58 Carroll Street
Lebanon, VA 24266
Phone: (276) 883-8000
Type: Location
21371 FORSYTHE RD
BRISTOL, VA 242024357
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $29.
Total Amount is formed as General ($29) + Research ($0) + Ownership ($0) = $29.
Last reported payment date: 2023-11-09 • Largest payer in this snapshot: Pacira Pharmaceuticals Incorporated ($15).
Total Amount
$29
General + Research + Ownership
Payments
2
Total payment records
General Amount
$29
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Pacira Pharmaceuticals Incorporated | $15 |
| Endo Pharmaceuticals Inc. | $15 |
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: 2021-10-28
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 |
|---|---|---|---|---|
| I20211028001077 | I | Physician Assistant | VA | 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 |
|---|---|---|---|---|
| J7320 | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg | 1,000 | 18 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 408 | 58 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 110 | 70 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 96 | 77 | $0 |
| 27447 | Replacement of knee joint, both sides of knee | 30 | 29 | $0 |
Insurance plans in this area (ZIP 37604)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | VA | |
| - | VA | |
| - | VA | |
| Nurse Practitioner | VA | |
| Nurse Practitioner | TN | |
| Mental Health Counselor | VA | |
| - | VA | |
| General Surgery | VA | |
| P S Y C H I A T R Y | VA | |
| General Surgery | VA |
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