JERRY DEWAYNE WILSON PA-C
NPI 1619153210
Physician Assistant - Medical in Tucker, GA

Q: What is Jerry Wilson's NPI number?

The NPI number for Jerry Wilson is 1619153210. It was assigned to this individual provider in the NPPES registry on January 14, 2008.

Q: What is Jerry Wilson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Jerry Wilson was last updated on December 6, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since January 14, 2008PECOS EnrolledAccepts Medicare Assignment

92.26/100

CMS Quality Rating

4500 HUGH HOWELL RD, SUITE, TUCKER, GA 30084(678) 632-4003(678) 681-1305 Get Directions Write a Review

NPPES record last updated: December 6, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jerry Dewayne Wilson Pa-c NPPES

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

JERRY DEWAYNE WILSON PA-C (NPI 1619153210) is an individual medical provider in Tucker, Georgia, licensed in Georgia (003052) and active in the NPI registry since January 2008. He is enrolled in Medicare PECOS, is affiliated with Emory Decatur Hospital, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1619153210

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameJERRY DEWAYNE WILSONCredential: PA-C

Location Address4500 HUGH HOWELL RD, SUITETucker, GA 30084-4723

Mailing AddressPo Box 360550Decatur, GA 30036-0550 · (678) 632-4003 · Fax (678) 681-1305

Phone(678) 632-4003

Fax(678) 681-1305

Sole ProprietorYes

Medical School CMSOtherGraduated 1997

Enumeration DateJanuary 14, 2008

Last NPPES UpdateDecember 6, 2010

✔ NPI 1619153210 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in GA · 003052

4500 HUGH HOWELL RD, Tucker, GA 30084

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Other Identifiers 2

Medicare UPINQ28376GA

Medicaid308036587AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jerry Dewayne Wilson Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6305800731

PECOS Enrollment IDI20041116000603

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

204 services88 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

23 services23 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

16 services14 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Emory Decatur Hospital

Acute Care Hospitals · Decatur, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110076

Location2701 N Decatur RoadDecatur, GA 30033 · De Kalb County

Emergency services Birthing friendly

Emory Hillandale Hospital

Acute Care Hospitals · Lithonia, GA

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110226

Location2801 Dekalb Medical ParkwayLithonia, GA 30058 · De Kalb County

Emergency services

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.26/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

73.83

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walker, with trunk support, adjustable or fixed height, any type E0140

DME-Other DME · category DE000N

1 supplier12 claims12 services$17.90 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRUCE ALAN PRESTON D.M.D

Dentist (General Practice)

4500 HUGH HOWELL RD, SUITE 310
TUCKER, GA 30084

Dekalb County (770) 938-3311

DR. DENELLA LAZENBY AUSBORN PSY.D.

Psychologist (Clinical)

4500 HUGH HOWELL RD, SUITE 740
TUCKER, GA 30084

Dekalb County (770) 938-4616

LAFAYETTE MEDICAL AND ALTERNATIVE HEALTH

Nursing Facility/Intermediate Care Facility

4500 HUGH HOWELL RD, 320
TUCKER, GA 30084

Dekalb County (770) 621-9405

STEWART FAMILY PRACTICE, PC

Family Medicine

4500 HUGH HOWELL RD, STE 220
TUCKER, GA 30084

Dekalb County (770) 469-0668

DR. JOO-WON KIM DDS

Dentist (General Practice)

4500 HUGH HOWELL RD, SUITE 140
TUCKER, GA 30084

Dekalb County (770) 938-9090

DEIRDRE BONAPARTE MA, CCC-SLP

Speech-Language Pathologist

4500 HUGH HOWELL RD, SUITE 780
TUCKER, GA 30084

Dekalb County (678) 462-1342

THE AUC INSTITUTE FOR CAREER STUDIES, INC.

Preferred Provider Organization

4500 HUGH HOWELL RD, SUITE 380
TUCKER, GA 30084

Dekalb County (678) 388-9770

DR. WILLIE F AUSBORN PSY.D

Psychologist (Clinical)

4500 HUGH HOWELL RD, SUITE 740
TUCKER, GA 30084

Dekalb County (770) 938-4616

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 Jerry Wilson's NPI number?

The NPI number for Jerry Wilson is 1619153210. It was assigned to this individual provider in the NPPES registry on January 14, 2008.

Where is Jerry Wilson located?

Jerry Wilson practices at 4500 Hugh Howell Rd Suite, Tucker, GA 30084. The listed phone number is (678) 632-4003.

What is Jerry Wilson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Jerry Wilson enrolled in Medicare?

Yes. Jerry Wilson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jerry Wilson accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Jerry 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.

Is Jerry Wilson affiliated with any hospitals?

According to CMS data, Jerry Wilson is affiliated with Emory Decatur Hospital and Emory Hillandale Hospital.

When was this NPI record last updated?

The NPPES record for Jerry Wilson was last updated on December 6, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.