MR. WILTON CRAIG KENNEDY (PA-C) – Medical Physician Assistant, NPI 1154475267
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in VA
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Provider Addresses for MR. WILTON CRAIG KENNEDY (PA-C)
2620, Avenham Avenue Southwest, Prospect Hills, Southern Hills, Roanoke, Virginia, 24014, United States
ROANOKE, VA 240141507
Phone: (540) 985-4016
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)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2024-01-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20071009000826 | I | Physician Assistant | VA | TBD |
| I20230628004206 | I | Physician Assistant | NC | TBD |
| I20240126001515 | I | Physician Assistant | DC | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 172 | 145 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 131 | 131 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 127 | 57 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 96 | 87 | $0 |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 82 | 72 | $0 |
Insurance plans in this area (ZIP 24014)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | VA | |
| Family Practice, Emergency Medicine, Family Practice | VA | |
| Physician Assistant | VA | |
| Nurse Practitioner | VA | |
| Physician Assistant | WV | |
| Physician Assistant | CT | |
| Physician Assistant | VA | |
| Nurse Practitioner | NY | |
| Physician Assistant | KS | |
| Physician Assistant | MA |
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