MR. KIM KEITH WIESE (PA-C) – Physician Assistant, NPI 1801866744
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MR. KIM KEITH WIESE (PA-C)
1524, West Glen Avenue, Metro West, Peoria, Peoria County, Illinois, 61614, United States
PEORIA, IL 616144692
Phone: (309) 512-0902
Fax: (309) 403-0397
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 1 Open Payments records for all available years, with a total value of $14.
Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.
Last reported payment date: 2024-04-09 • Largest payer in this snapshot: Abbott Laboratories ($14).
Total Amount
$14
General + Research + Ownership
Payments
1
Total payment records
General Amount
$14
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $14 |
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: 2022-10-12
PECOS data refreshed: 2026-05-27
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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 61614)
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Reviews
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