JENNIFER WILSON (PA-C) – Physician Assistant, NPI 1174906176

JENNIFER WILSON (PA-C) is a healthcare provider. based in Lynnwood, Washington. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA60554438 (WA). The NPI Number for JENNIFER WILSON (PA-C) is 1174906176

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER WILSON (PA-C)
NPI
1174906176
Phone
Not provided
Address
4111 194TH ST SW
Enumeration Date
8 July 2015
Last Update Date
21 September 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2015 (11 years ago)
PAC ID
5294041836
Group Practice PAC ID
3779895396
Professional Enrollment ID
I20150827002589
Address ID
WA983622609PO240XXAXXX500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

4,282 PHYSICIAN ASSISTANT in WA

Provider Addresses for JENNIFER WILSON (PA-C)

  • 4111 194TH ST SW

    LYNNWOOD, WA 980364604

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2015-08-27

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150827002589IPhysician AssistantWATBD

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
85610Blood test, clotting time11149$0
81003Automated urinalysis test3030$0
81002Urinalysis, manual test1111$0
View full utilization report →

Insurance plans in this area (ZIP 98036)

Loading plans...

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: 3779895396View full group profile
NameSpecialtyState
Nurse PractitionerWA
-WA
Nurse PractitionerWA
Family PracticeWA
O P T O M E T R YAK
Family Practice, Obstetrics/GynecologyWA
Family PracticeWA
O P T O M E T R YWA
Nurse PractitionerWA
Family PracticeWA

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.

Frequently asked questions

Can I use this page to confirm JENNIFER WILSON (PA-C)'s NPI?
Yes. JENNIFER WILSON (PA-C) is listed with NPI 1174906176 in the public NPI dataset.
Is JENNIFER WILSON (PA-C) listed as active for patients and plans?
The listing shows JENNIFER WILSON (PA-C) as active in the NPI system.
What is JENNIFER WILSON (PA-C)'s primary classification?
Physician Assistant is the headline specialty for JENNIFER WILSON (PA-C) here. Clinical services aligned with this taxonomy classification.
What address line appears for JENNIFER WILSON (PA-C)?
JENNIFER WILSON (PA-C)'s geographic hint is Lynnwood, Washington in our summary view.
Is the information about JENNIFER WILSON (PA-C) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

Similar Providers

PATRICK KELLY SMITH (PAC)

Physician Assistant
1522, Janes Avenue, Saginaw, Saginaw County, Michigan, 48601, United States
NPI: 1124016951

GEORDIE MCGILL GLASS (PA-C)

Medical Physician Assistant
33rd Avenue West, Lynnwood, Snohomish County, Washington, 98037, United States
NPI: 1386622546

MR. KIRBY F. MEYER (PA-C)

Physician Assistant
33rd Avenue West, Lynnwood, Snohomish County, Washington, 98037, United States
NPI: 1811969769

PAUL DAVID MORTLOCK (PA-C)

Medical Physician Assistant
2101 NE 139th St Ste 380
NPI: 1376506733

MS. JOYCE M HOGAN (PA-C)

Physician Assistant
1001 BROADWAY STE 309
NPI: 1417964354

Unknown Individual

Physician Assistant
12721 30th Ave NE
NPI: 1760490320

RIZWANNA LOTT (PAC)

Physician Assistant
33rd Avenue West, Lynnwood, Snohomish County, Washington, 98037, United States
NPI: 1992718464

TROY BRYAN SCHULZ (PA-C)

Medical Physician Assistant
19020 33RD AVE W STE 210
NPI: 1649386806

MS. KIRA SUSAN VADER (PA-C)

Physician Assistant
8915, 217th Street Southwest, Edmonds, Snohomish County, Washington, 98026, United States
NPI: 1689775876