TIFFANY KAY WILSON (P.A.) – Physician Assistant, NPI 1710920178
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,491 PHYSICIAN ASSISTANT in TX
Provider Addresses for TIFFANY KAY WILSON (P.A.)
412 W SOUTH ST
HENRIETTA, TX 763653348
Phone: (940) 235-3403
Fax: (580) 272-0186
Type: Location
301, North Monte Vista Street, Ada, Pontotoc County, Oklahoma, 74820, United States
ADA, OK 748204607
Phone: (580) 436-2262
Fax: (580) 272-0186
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 22 Open Payments records for all available years, with a total value of $497.
Total Amount is formed as General ($497) + Research ($0) + Ownership ($0) = $497.
Last reported payment date: 2024-11-19 • Largest payer in this snapshot: ABBVIE INC. ($327).
Total Amount
$497
General + Research + Ownership
Payments
22
Total payment records
General Amount
$497
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $327 |
| Corcept Therapeutics | $79 |
| Novo Nordisk Inc | $58 |
| Baxter Healthcare | $18 |
| PFIZER 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: 2014-08-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20050120000904 | I | Physician Assistant | TX | TBD |
| I20140806000919 | I | Physician Assistant | OK | 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 76365)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice, Emergency Medicine | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX |
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