OTHON WILTZ (M.D.) – Colon & Rectal Surgery Physician, NPI 1174525869
Colon & Rectal Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
68 COLORECTAL SURGERY (PROCTOLOGY) in VA
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Provider Addresses for OTHON WILTZ (M.D.)
3620, Joseph Siewick Drive, Chantilly, Fairfax (city), Virginia, 22033, United States
SUITE 406
FAIRFAX, VA 22033
Phone: (703) 359-8640
Fax: (703) 591-6105
Type: Mailing
Joseph Siewick Drive, Chantilly, Fairfax (city), Virginia, 22033, United States
FAIRFAX, VA 220331761
Phone: (703) 359-8640
Fax: (703) 591-6105
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $4,043.
Total Amount is formed as General ($4,043) + Research ($0) + Ownership ($0) = $4,043.
Last reported payment date: 2024-03-26 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($4,000).
Total Amount
$4,043
General + Research + Ownership
Payments
3
Total payment records
General Amount
$4,043
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-26
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2020-03-23
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 |
|---|---|---|---|---|
| I20200323002387 | I | Colorectal Surgery (Proctology) | NY | 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 | 51 | 31 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 30 | 30 | $0 |
Insurance plans in this area (ZIP 22033)
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Group practice members
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