AMANDA PATTERSON WICKSON (PA-C) – Physician Assistant, NPI 1710177464
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for AMANDA PATTERSON WICKSON (PA-C)
808, Keller Parkway, Old Town Keller, Keller, Tarrant County, Texas, 76248, United States
KELLER, TX 762482405
Phone: (817) 431-2573
Fax: (817) 379-6881
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 $326.
Total Amount is formed as General ($326) + Research ($0) + Ownership ($0) = $326.
Last reported payment date: 2024-10-24 • Largest payer in this snapshot: Phathom Pharmaceuticals, Inc. ($110).
Total Amount
$326
General + Research + Ownership
Payments
18
Total payment records
General Amount
$326
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Phathom Pharmaceuticals, Inc. | $110 |
| ABBVIE INC. | $59 |
| Bayer Healthcare Pharmaceuticals Inc. | $45 |
| Lilly USA, LLC | $29 |
| Corcept Therapeutics | $21 |
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: 2011-01-28
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 |
|---|---|---|---|---|
| I20110128000114 | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 41 | 26 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 27 | 17 | $0 |
| G0444 | Annual depression screening, 5 to 15 minutes | 13 | 13 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 12 | 12 | $0 |
Insurance plans in this area (ZIP 76248)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TX |
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