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DR. KEITH PETER WILSON DDS
NPI 1346391976
Dentist - General Practice in Peotone, IL

Active since January 12, 2007PECOS Enrolled
211 N SECOND ST, PO 727, PEOTONE, IL 60468(708) 258-3331 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Keith Peter Wilson Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEITH PETER WILSON DDS (NPI 1346391976) is an individual general practice provider in Peotone, Illinois and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of Univ Of Illinois At Chicago College Of Dentistry (1997).

NPPES Registry Identity

NPI1346391976
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. KEITH PETER WILSONCredential: DDS
Location Address211 N SECOND ST, PO 727Peotone, IL 60468-8837
Mailing Address22533 Oakfield DrFrankfort, IL 60423-9012 · (815) 534-5160
Phone(708) 258-3331
Sole ProprietorNo
Medical School CMSUniv Of Illinois At Chicago College Of DentistryGraduated 1997
Enumeration DateJanuary 12, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1346391976 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
211 N SECOND ST, Peotone, IL 60468
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Keith Peter Wilson Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4981955887
PECOS Enrollment IDI20260414002113
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Keith Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Tca Health Inc Nfp
25 mi
Federally Qualified Health Center (FQHC)
1029 E 130TH ST
Chicago, IL 60628
  • Reassigned Medicare billing, Illinois enrollment
  • 36 clinicians in this Medicare group
NPI 1184757353 (773) 995-6300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60468 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$74.38 typical visit price
range $19.15 – $147.12
Typical copayment $18.59 (range $4.78 – $36.78)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keith Wilson's NPI number?

The NPI number for Keith Wilson is 1346391976. It was assigned to this individual provider in the NPPES registry on January 12, 2007.

Where is Keith Wilson located?

Keith Wilson practices at 211 N Second St PO 727, Peotone, IL 60468. The listed phone number is (708) 258-3331.

What is Keith Wilson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Keith Wilson enrolled in Medicare?

Yes. Keith Wilson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Keith Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Keith Wilson reassigns Medicare benefits to Tca Health Inc Nfp (Chicago, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Keith Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Keith Wilson accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield, BEST Life and Blue Cross and Blue Shield of Montana and 8 other insurers list Keith Wilson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Keith Wilson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.