LACEE WILKINSON (PA-C) – Surgical Physician Assistant, NPI 1164709630
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
Provider Addresses for LACEE WILKINSON (PA-C)
3550 N UNIVERSITY AVE STE 250
PROVO, UT 846046695
Phone: (801) 374-9625
Fax: (801) 374-9690
Type: Mailing
1441 Florida Ave
Modesto, CA 953504404
Phone: (209) 578-1211
Type: Location
3550 N University Ave Ste 250
Provo, UT 84604
Phone: (801) 374-9625
Fax: (801) 374-9690
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $16.
Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.
Last reported payment date: 2024-02-07 • Largest payer in this snapshot: Integra LifeSciences Corporation ($16).
Total Amount
$16
General + Research + Ownership
Payments
1
Total payment records
General Amount
$16
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Integra LifeSciences Corporation | $16 |
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: 2012-04-16
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 |
|---|---|---|---|---|
| I20120416000530 | I | Physician Assistant | UT | 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 84604)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OR | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | UT | |
| General Surgery | UT | |
| Nurse Practitioner | UT | |
| General Surgery | UT | |
| General Surgery | OR | |
| Nurse Practitioner | UT | |
| - | UT |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.