Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1235353988 Individual Practitioner Female Practitioner

Katherine Ann Wilson , PA-C

Physician Assistant • St. Johns, FL

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Katherine Wilson, PA-C is a certified Physician Assistant practicing in St. Johns, FL. With approximately 19 years of clinical experience since completing medical education in 2007, Katherine Wilson delivers high-quality medical care to the local community at 30 ARDISIA LANE.

Katherine Wilson is affiliated with Baptist Primary Care Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include insertion of needle into vein for collection of blood sample, established patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

30 Ardisia Lane

St. Johns, FL 32259

Telephone 9042872794
Fax 9043907458
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2007

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in St. Johns, FL

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
19 Yrs +8.1 yrs vs City Avg
City Avg: 10.9 Yrs
State Avg: 11.1 Yrs
Regional Practice Density
11 Specialists

Practicing in St. Johns, FL (10376 Statewide)

Telehealth Adoption Rate
45.5% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
62.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wilson (19 Years) 19 Yrs
St. Johns Specialty Average (10.9 Years) 10.9 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample
112 79 $16.06 $8.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
104 73 $314.87 $106.87
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more
98 70 $445.77 $149.57
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
94 94 $320.91 $106.83
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's
66 50 $41.00 $13.78
93000 Routine ekg using at least 12 leads including interpretation and report
45 44 $36.04 $11.92
99213 Established patient office or other outpatient visit, typically 15 minutes
18 17 $224.33 $75.78
81003 Automated urinalysis test
17 13 $6.00 $2.20
G0008 Administration of influenza virus vaccine
15 15 $74.00 $31.66
90673 Influenza vaccine, trivalent derived from recombinant dna
14 14 $70.00 $68.60

Medical Specialties & State Licenses

CMS Verified: 2022-09-15
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License FL PA9104552

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License GA 005035

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
411072211A (GA)

Hospital & Practice Group Affiliations

Baptist Primary Care Inc

10898 Baymeadows Rd, Jacksonville, FL 322565838

Phone: 9045195338

Secondary Practice Locations

559 W Twincourt Trl Unit 601

St Augustine, FL 320958805

Phone: 9049401441

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Dr. Kanaklakshmi Masodkar , MD

Psychiatry & Neurology - Psychiatry

NPI 1164860748

Doctor of Medicine (M.D.)

NPI 1194796813

Doctor of Osteopathic Medicine (D.O.)

Nineveh Mcintosh , PA-C

Physician Assistant

NPI 1730430893

Physician Assistant (Certified)

Kelsey Bloom , LCSW

Social Worker - Clinical

NPI 1730892365

Licensed Clinical Social Worker

NPI 1770041477

Doctor of Osteopathic Medicine (D.O.)

Carol Noell , PA-C

Physician Assistant - Medical

NPI 1821167065

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location September 20, 2022

Registered at 30 ARDISIA LANE, ST. JOHNS, FL 32259 (Tel: 9042872794)

📍
Updated Business Mailing Address September 20, 2022

Registered at PO BOX 746638, ATLANTA, GA 303746638 (Tel: 9042021032)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 20, 2022

Physician Assistant (License #005035 in GA)

📍
Updated Business Mailing Address December 31, 2018

Registered at PO BOX 45443, SALT LAKE CITY, UT 841450443 (Tel: 9042021032)

NPI Profile Active November 20, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location November 20, 2015

Registered at 559 W TWINCOURT TRL UNIT 601, ST AUGUSTINE, FL 320958805 (Tel: 9049401441)

📍
Updated Business Mailing Address November 20, 2015

Registered at PO BOX 44004, JACKSONVILLE, FL 322314004 (Tel: 9042021032)

👤
Provider Name / Credentials Updated November 20, 2015

Recorded as KATHERINE WILSON, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 20, 2015

Physician Assistant (License #PA9104552 in FL)

🟢
Initial NPI Registration & Enumeration April 12, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1235353988
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 12, 2007
Last Update: September 20, 2022
Sole Proprietor: No

Mailing Address

Po Box 746638

Atlanta, GA 303746638

Phone: 9042021032

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.