Mrs Katherine Ann Wilson, PA-C - Medicare Physician Assistant in St. Johns, FL

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Mrs Katherine Ann Wilson, PA-C is a medicare enrolled "Physician Assistant" in St. Johns, Florida. She graduated from nursing school in 2007 and has 19 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Baptist Primary Care Inc and her current practice location is 30 Ardisia Lane, St. Johns, Florida. You can reach out to her office (for appointments etc.) via phone at (904) 287-2794.

Mrs Katherine Ann Wilson is licensed to practice in Florida (license number PA9104552) 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 1235353988.

Contact Information

Mrs Katherine Ann Wilson, PA-C
30 Ardisia Lane,
St. Johns, FL 32259
(904) 287-2794
(904) 390-7458

Map and Direction




Provider's Profile

Full NameMrs Katherine Ann Wilson
GenderFemale
SpecialityPhysician Assistant
Experience19 Years
Location30 Ardisia Lane, St. Johns, Florida
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mrs Katherine Ann Wilson graduated from nursing school in 2007
  NPI Data:
  • NPI Number: 1235353988
  • Provider Enumeration Date: 04/12/2007
  • Last Update Date: 09/20/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 0941308787
  • Enrollment ID: I20111107000709

Medical Identifiers

Medical identifiers for Mrs Katherine Ann Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1235353988NPI-NPPES
411072211AMedicaidGA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 005035 (Georgia)Secondary
363A00000XPhysician Assistant PA9104552 (Florida)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Baptist Medical Center JacksonvilleJacksonville, FLHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Baptist Primary Care Inc0648177733459

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. Mrs Katherine Ann Wilson allows following entities to bill medicare on her behalf.
Entity NameBaptist Primary Care Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1508817529
PECOS PAC ID: 0648177733
Enrollment ID: O20031217000248

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. Mrs Katherine Ann 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 AddressPractice Location Address
Mrs Katherine Ann Wilson, PA-C
Po Box 746638,
Atlanta, GA 30374-6638

Ph: (904) 202-1032		Mrs Katherine Ann Wilson, PA-C
30 Ardisia Lane,
St. Johns, FL 32259

Ph: (904) 287-2794

Reviews and Comments


Physician Assistant Nurses in St. Johns, FL

Shanjida Rauf,
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 616 State Road 13, Ste 8, St. Johns, FL 32259
Phone: 904-512-1899    Fax: 904-770-7592
Nineveh A Mcintosh, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 30 Ardisia Lane, St. Johns, FL 32259
Phone: 904-287-2794    Fax: 904-390-7458
Vanessa M. Berrios, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 30 Ardisia Lane, St. Johns, FL 32259
Phone: 904-287-2794    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.