Individual provider Active NPI

Michael A Wiles, PA

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1033210133
Registry record updated Jul 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA130 Issued in KY
Practice address
3480 Yorkshire Medical Park
Lexington, KY 40509-1886
Phone
(859) 263-5140
Fax
(859) 263-5141
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA130 KY Primary

Addresses

Primary practice location

3480 Yorkshire Medical Park
Lexington, KY 40509-1886

Mailing address

3480 Yorkshire Medical Park
Lexington, KY 40509-1886
Phone (859) 263-5140

Other identifiers 1

IdentifierTypeStateIssuer
95001301MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050413000859 KY Practitioner - Physician Assistant 5395782197 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harrison Memorial HospitalGroup PAC ID 4284784067, 60 clinicians

Practice addresses (Care Compare)

1210 Ky Hwy 36 E
Suite G3
Cynthiana, KY 41031-7492
Phone (859) 235-3638

439 E Pleasant St
Cynthiana, KY 41031-1827
Phone (859) 234-4494

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bluegrass Orthopaedics PSC Physician Assistant CurrentSince Mar 1, 2017 Accepting new patients

Locations

101 Windsor Path
Georgetown, KY 40324
Phone (502) 868-6106

3480 Yorkshire Medical Park
Lexington, KY 40509
Phone (859) 303-8803

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500508800000",
    "number": "1033210133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 YORKSHIRE MEDICAL PARK",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091886",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3480 YORKSHIRE MEDICAL PARK",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091886",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2017-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95001301",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.