Carly Anne Wilson, PA is a medicare enrolled "Physician Assistant" in Raphine, Virginia. She graduated from nursing school in 2021 and has 5 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Privia Medical Group, Llc and her current practice location is
25 Commerce Park Dr, Raphine, Virginia. You can reach out to her office (for appointments etc.) via phone at
(540) 490-2527.
Carly Anne Wilson is licensed to practice in Virginia (license number 0110008398) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1316698582.
Provider's Profile
| Full Name | Carly Anne Wilson |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 5 Years |
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| Location | 25 Commerce Park Dr, Raphine, Virginia |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Carly Anne Wilson graduated from nursing school in 2021
NPI Data:
- NPI Number: 1316698582
- Provider Enumeration Date: 01/10/2022
- Last Update Date: 03/14/2022
Medicare PECOS Information:
- PECOS PAC ID: 3870971674
- Enrollment ID: I20220607002586
Medical Identifiers
Medical identifiers for Carly Anne Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1316698582 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | 0110008398 (Virginia) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Privia Medical Group, Llc | 4385682061 | 1522 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Carly Anne Wilson allows following entities to bill medicare on her behalf.
| Entity Name | Privia Medical Group, LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013042480
PECOS PAC ID: 4385682061
Enrollment ID: O20140603000011 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Carly Anne Wilson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Carly Anne Wilson, PA
40 Ball Diamond Trl,
Vesuvius, VA 24483-2901
Ph: (540) 421-0578 | Carly Anne Wilson, PA
25 Commerce Park Dr,
Raphine, VA 24472-2547
Ph: (540) 490-2527 |
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