ILI WATHEN (PA-C) – Physician Assistant, NPI 1063722577
Preparing for Medicare enrollment?
Use our CMS-855 prep checklist: which form applies (855I, 855O, or 855A), readiness score, NPPES field map, and Section 12 documents. Reassignment uses CMS-855I Section 4F—not the discontinued CMS-855R form.
Open Medicare 855 Prep tool →Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for ILI WATHEN (PA-C)
5000 COX RD
GLEN ALLEN, VA 230609263
Phone: (804) 968-5700
Type: Mailing
2855 CRAIN HWY
WALDORF, MD 206012840
Phone: (240) 427-1926
Type: Location
11565 FARM DR
LA PLATA, MD 206465417
Phone: (301) 752-3667
Fax: (240) 222-3134
Type: Mailing
3500 OLD WASHINGTON RD STE 201
WALDORF, MD 206023238
Phone: (301) 396-2003
Fax: (240) 222-3134
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $88.
Total Amount is formed as General ($88) + Research ($0) + Ownership ($0) = $88.
Last reported payment date: 2023-08-04 • Largest payer in this snapshot: Lilly USA, LLC ($27).
Total Amount
$88
General + Research + Ownership
Payments
4
Total payment records
General Amount
$88
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $27 |
| Abbott Laboratories | $25 |
| PFIZER INC. | $20 |
| SANOFI PASTEUR INC. | $16 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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 23060)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MD | |
| - | MD | |
| - | MD | |
| Nurse Practitioner | VA | |
| Preventive Medicine | FL | |
| Family Practice | VA | |
| - | VA | |
| - | VA | |
| Emergency Medicine | MD | |
| Emergency Medicine | VA |
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.