MR. WILDON MELLINGER III ROUSE – Physician Assistant, NPI 1003873845
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,491 PHYSICIAN ASSISTANT in TX
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Provider Addresses for MR. WILDON MELLINGER III ROUSE
1253, North Von Minden Street, La Grange, Fayette County, Texas, 78945, United States
LA GRANGE, TX 789451262
Phone: (979) 968-8493
Fax: (979) 968-6388
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 18 Open Payments records for all available years, with a total value of $310.
Total Amount is formed as General ($310) + Research ($0) + Ownership ($0) = $310.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Amgen Inc. ($94).
Total Amount
$310
General + Research + Ownership
Payments
18
Total payment records
General Amount
$310
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
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: 2005-10-27
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 |
|---|---|---|---|---|
| I20051027000329 | I | Physician Assistant | TX | 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 | 528 | 59 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 427 | 302 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 202 | 133 | $0 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 144 | 34 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 108 | 67 | $0 |
Insurance plans in this area (ZIP 78945)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | TX | 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 18 | 18 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TX | |
| Family Practice | IL | |
| Family Practice | TX | |
| Nurse Practitioner | TX | |
| Family Practice | TX | |
| Family Practice | TX | |
| - | TX | |
| Physician Assistant | TX | |
| - | TX | |
| Family Practice, General Surgery | TX |
Reviews
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