TYSON WILCOX – Physician Assistant, NPI 1194379040

TYSON WILCOX is a healthcare provider. based in Draper, Utah. specializing in PHYSICIAN ASSISTANT. The NPI Number for TYSON WILCOX is 1194379040

Main info

Male
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
TYSON WILCOX
NPI
1194379040
Phone
(801) 592-7884
Address
11593 S DOUGLAS VISTA DR
Enumeration Date
30 July 2019
Last Update Date
29 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8015618398
Graduation Year
2019 (7 years ago)
PAC ID
1759773179
Group Practice PAC ID
2264973437
Professional Enrollment ID
I20220117000023
Address ID
UT840953946SO406XXPKWY501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience27
Completeness75
Years active:6State licenses:0Digital endpointsOther names

1,981 PHYSICIAN ASSISTANT in UT

Provider Addresses for TYSON WILCOX

  • 11593 S DOUGLAS VISTA DR

    DRAPER, UT 840201480

    Phone: (801) 592-7884

    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 9 Open Payments records for all available years, with a total value of $677.

Total Amount is formed as General ($677) + Research ($0) + Ownership ($0) = $677.

Last reported payment date: 2024-02-19 • Largest payer in this snapshot: Boston Scientific Corporation ($677).

Total Amount

$677

General + Research + Ownership

Payments

9

Total payment records

General Amount

$677

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2022-01-17

PECOS data refreshed: 2026-06-15

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220117000023IPhysician AssistantUTTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes9694$0
81003Automated urinalysis test2222$0
99203New patient office or other outpatient visit, 30-44 minutes2222$0
71046X-ray of chest, 2 views1515$0
View full utilization report →

Insurance plans in this area (ZIP 84020)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2264973437View full group profile
NameSpecialtyState
Physician AssistantWA
Nurse PractitionerUT
Nurse PractitionerUT
Family PracticeUT
Nurse PractitionerUT
Nurse PractitionerUT
Nurse PractitionerUT
Family PracticeNV

Reviews

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Frequently asked questions

What is the 10-digit NPI for TYSON WILCOX?
TYSON WILCOX — NPI 1194379040 — is the standard way to identify this listing.
Is TYSON WILCOX listed as active for patients and plans?
The listing shows TYSON WILCOX as active in the NPI system.
What is TYSON WILCOX's primary classification?
Physician Assistant is the headline specialty for TYSON WILCOX here. Clinical services aligned with this taxonomy classification.
What area does TYSON WILCOX serve?
TYSON WILCOX's listing highlights Draper, Utah; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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