Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Katherine Ann Wilson , PA-C

Physician Assistant โ€ข St. Johns, FL

Active NPI 1235353988 Individual Practitioner Female Practitioner Accepts Medicare assignment Telehealth (some services)
Practice location in NPPES

30 Ardisia Lane
St. Johns, FL 32259

Call 9042872794 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

30 Ardisia Lane

St. Johns, FL 32259

Telephone 9042872794
Fax 9043907458
Organization at the Same NPPES Address or Phone
Fruit Cove Family Medicine P A Facility NPI 1629195300

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in St Augustine, FL. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

CMS Doctors and Clinicians lists 1 group name: Baptist Primary Care Inc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2007

Medicare patients

177 people with Original Medicare in 2024

Different Original Medicare patients in 2024; counts below 11 are hidden; this does not show availability or quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider, 2024.

Medicare-allowed amount

About $41,066 in 2024

The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.

What this does not show: Medicare-allowed amount

This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

Paid by Medicare

About $32,388 in 2024

The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.

What this does not show: Paid by Medicare

This is not the clinician's income and not a measure of quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

30-day fills

1,408 standardized 30-day fills in 2024

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$5,438 in 2024

The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers โ€“ by Provider and Drug, 2024.

Open Payments general payments, program year 2025

All general payments: $605.50 across 33 records.

By nature of payment

  • Food and Beverage: $605.50 across 33 records.

Reporting-company totals (3 largest of 12)

  • ABBVIE INC.: $150.67 across 8 records.
  • Novo Nordisk Inc: $144.41 across 10 records.
  • Otsuka America Pharmaceutical, Inc.: $73.07 across 3 records.

A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.

See the full table

Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).

Guide: How to read an Open Payments record

Years since graduation

19 years (graduated 2007)

CMS Doctors and Clinicians data list 2007 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2007

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, โ€œDoes your provider accept Medicare as full payment?โ€

Guide: What Medicare assignment means

Telehealth (some services)

Recent Medicare claims show this clinician provided some services by telehealth, such as a video or phone visit.

What this does not show: Telehealth (some services)

It does not mean all services are offered by telehealth, or that telehealth is covered by your plan.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Katherine Wilson has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Katherine Wilson as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in St. Johns and Florida

Billing and prescribing volume is not a quality rating.

Medicare Part B services

More Medicare Part B services than 65% of clinicians listed under Physician Assistant in Florida (2024, 4,397 clinicians with data). Median for this group: 252. Middle half: 82 to 807.

Too few clinicians listed under Physician Assistant in St. Johns have Medicare Part B data for 2024 to compare.

Medicare-allowed amount

A higher Medicare-allowed amount than 65% of clinicians listed under Physician Assistant in Florida (2024, 4,397 clinicians with data). Median for this group: $19,984. Middle half: $7,371 to $51,670.

Too few clinicians listed under Physician Assistant in St. Johns have Medicare Part B data for 2024 to compare.

Paid by Medicare

A higher Medicare payment amount than 70% of clinicians listed under Physician Assistant in Florida (2024, 4,397 clinicians with data). Median for this group: $14,814. Middle half: $5,414 to $38,190.

Too few clinicians listed under Physician Assistant in St. Johns have Medicare Part B data for 2024 to compare.

Medicare Part D prescriptions

More Part D prescriptions than 60% of clinicians listed under Physician Assistant in Florida (2024, 4,894 clinicians with data). Median for this group: 270. Middle half: 78 to 825.

Too few clinicians listed under Physician Assistant in St. Johns have Medicare Part D data for 2024 to compare.

Part D drug cost

Close to the middle for clinicians listed under Physician Assistant in Florida (2024, 4,894 clinicians with data). Median for this group: $5,225. Middle half: $703 to $70,250.

Too few clinicians listed under Physician Assistant in St. Johns have Medicare Part D data for 2024 to compare.

11 active clinicians are listed under Physician Assistant with a practice address in St. Johns, FL (10,260 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in St. Johns

45.5% of these 11 clinicians have the CMS telehealth indicator.

63.6% of these 11 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo ยท Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments ยท Program Year 2025
Disclosure Year:

Program year 2025 (payments made January 1 โ€“ December 31, 2025): 33 records totaling $605.50.

Manufacturer Payment Nature Product Type Amount ($)
Daiichi Sankyo Inc.
Food and Beverage
In-kind items and services
INJECTAFER General $29.55
Bayer Healthcare Pharmaceuticals Inc.
Food and Beverage
In-kind items and services
Kerendia General $28.33
Otsuka America Pharmaceutical, Inc.
Food and Beverage
In-kind items and services
REXULTI General $27.95
Otsuka America Pharmaceutical, Inc.
Food and Beverage
In-kind items and services
REXULTI General $25.67
ABBVIE INC.
Food and Beverage
In-kind items and services
QULIPTA General $23.53
ABBVIE INC.
Food and Beverage
In-kind items and services
QULIPTA General $23.53
Novo Nordisk Inc
Food and Beverage
In-kind items and services
Ozempic General $23.38
GlaxoSmithKline, LLC.
Food and Beverage
In-kind items and services
SHINGRIX General $22.60
ABBVIE INC.
Food and Beverage
In-kind items and services
VRAYLAR General $21.89
Astellas Pharma US Inc
Food and Beverage
In-kind items and services
Veozah General $20.90
Pfizer Inc.
Food and Beverage
In-kind items and services
NURTEC ODT General $20.19
AstraZeneca Pharmaceuticals LP
Food and Beverage
In-kind items and services
BREZTRI General $20.00
Novo Nordisk Inc
Food and Beverage
In-kind items and services
Wegovy General $19.86
Novo Nordisk Inc
Food and Beverage
In-kind items and services
Ozempic General $19.79
Otsuka America Pharmaceutical, Inc.
Food and Beverage
In-kind items and services
REXULTI General $19.45
GlaxoSmithKline, LLC.
Food and Beverage
In-kind items and services
SHINGRIX General $19.30
Novo Nordisk Inc
Food and Beverage
In-kind items and services
Wegovy General $19.05
ABBVIE INC.
Food and Beverage
In-kind items and services
VRAYLAR General $18.46
ABBVIE INC.
Food and Beverage
In-kind items and services
UBRELVY General $17.62
Boehringer Ingelheim Pharmaceuticals, Inc.
Food and Beverage
In-kind items and services
JARDIANCE General $17.15
Novo Nordisk Inc
Food and Beverage
In-kind items and services
Wegovy General $17.04
ABBVIE INC.
Food and Beverage
In-kind items and services
VRAYLAR General $15.83
Novo Nordisk Inc
Food and Beverage
In-kind items and services
Rybelsus General $15.60
ABBVIE INC.
Food and Beverage
In-kind items and services
UBRELVY General $15.48
Amgen Inc.
Food and Beverage
In-kind items and services
REPATHA General $15.33

(top 25 shown)

Source: CMS Open Payments, program year 2025, released June 30, 2026.

Performed Procedures & Service Volume

Services billed to Original Medicare Part B in 2024.

CMS Part B ยท Data Year 2024
Reporting Year:

CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016โ€“2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ€“ by Provider and Service data, 2017โ€“2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

HCPCS Code 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 electrocardiogram (ecg) using at least 12 leads with interpretation and report
45 44 $36.04 $11.92
99213 Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
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

Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits

Submitted charges are billed amounts, not a price quote for your visit.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2024.

CMS Part D ยท Data Year 2024
Prescription Year:
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Atorvastatin Calcium Atorvastatin Calcium 46 4,131 $379.88 26
Hydrochlorothiazide Hydrochlorothiazide 37 3,270 $161.74 15
Levothyroxine Sodium Levothyroxine Sodium 36 3,174 $334.71 19
Rosuvastatin Calcium Rosuvastatin Calcium 34 3,060 $400.89 17
Amlodipine Besylate Amlodipine Besylate 31 2,740 $201.31 18
Metoprolol Succinate Metoprolol Succinate 28 2,460 $319.65 15
Lisinopril Lisinopril 27 2,325 $460.15 15
Omeprazole Omeprazole 27 2,405 $337.93 15
Simvastatin Simvastatin 25 2,130 $230.00 11
Losartan Potassium Losartan Potassium 25 2,190 $212.78 13
Metformin Hcl Metformin Hcl 21 1,890 $263.14 โ€”
Pantoprazole Sodium Pantoprazole Sodium 21 1,890 $197.38 โ€”
Duloxetine Hcl Duloxetine Hcl 19 1,710 $333.45 โ€”
Albuterol Sulfate Hfa Albuterol Sulfate 18 564 $323.60 โ€”
Gabapentin Gabapentin 17 1,270 $326.65 11
Olmesartan Medoxomil Olmesartan Medoxomil 15 1,230 $270.34 โ€”
Trazodone Hcl Trazodone Hcl 13 700 $152.79 โ€”
Montelukast Sodium Montelukast Sodium 12 1,090 $103.76 โ€”
Venlafaxine Hcl Er Venlafaxine Hcl 12 1,080 $225.50 โ€”
Sertraline Hcl Sertraline Hcl 11 990 $92.64 โ€”
Amlodipine Besylate-Benazepril Amlodipine Besylate/Benazepril 11 930 $63.00 โ€”
Benazepril Hcl Benazepril Hcl 11 900 $47.14 โ€”

Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-09-15
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES 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

License # reported to NPPES 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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
411072211A (GA)

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20111107000709

Enrollment State Jurisdiction

FL

PECOS Control ID

0941308787

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

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

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

10 listed
Vanessa Berrios , PA-C

Physician Assistant

NPI 1982977096

Physician Assistant (Certified)

Kelsey Bloom , LCSW

Social Worker - Clinical

NPI 1730892365

Licensed Clinical Social Worker

Nicole Fifer , PA-C

Physician Assistant

NPI 1861404899

Physician Assistant (Certified)

NPI 1770041477

Doctor of Osteopathic Medicine (D.O.)

NPI 1194796813

Doctor of Osteopathic Medicine (D.O.)

Dr. Donald Levine , MD

Family Medicine

NPI 1982673745

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
๐Ÿ“
Updated Practice Location September 20, 2022

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

๐Ÿ“
Updated Business Mailing Address September 20, 2022

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

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 20, 2022

Physician Assistant (license number reported to NPPES: GA 005035)

๐Ÿ“
Updated Business Mailing Address December 31, 2018

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

โœ…
NPI Profile Active November 20, 2015

NPI status registered as active in NPPES database

๐Ÿ“
Practice Location (Initial Record) November 20, 2015

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

๐Ÿ“
Business Mailing Address (Initial Record) November 20, 2015

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

๐Ÿ‘ค
Provider Name / Credentials (Initial Record) November 20, 2015

Recorded as KATHERINE WILSON, PA-C

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 20, 2015

Physician Assistant (license number reported to NPPES: FL PA9104552)

๐ŸŸข
Initial NPI Registration & Enumeration April 12, 2007

First registered as active Individual Practitioner in NPPES Database.

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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

Other Physician Assistants in St. Johns

Mailing Address

Po Box 746638

Atlanta, GA 303746638

Phone: 9042021032

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.