Doctor profile · Federal record
Dr. LACEY WILDEBOER, PA
Physician Assistant · KENLY, NC
- NPI 1477077089
- Accepts Medicare
- 9 yrs in practice
- Female
- Group practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
400 N ENGLEWOOD DR
KENLY, NC 275429290
(919) 284-4149
fax (919) 284-6008 - Additional location
-
7201 US Highway 64 E
Knightdale, NC 275459268
(919) 266-7600 - Mailing address
-
5221 PARAMOUNT PKWY STE 220
MORRISVILLE, NC 275605490
Credentials & registration
- NPI registered
- July 2017 — 9 yrs on file
- Profile last updated
- October 3, 2025
- Year of graduation
- 2017 — 9 yrs since
- Specialty taxonomy
- 363A00000X — NUCC code
- State license (1)
- North Carolina #0010-07379
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1477077089. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
31
Distinct HCPCS
2
Medicare allowed
$2,499
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
99213 |
Established patient office or other outpatient visit, 20-29 minutes | 18 | 18 | $73 | |
99203 |
New patient office or other outpatient visit, 30-44 minutes | 13 | 13 | $91 |
In context: peer comparison
Among 1 peers in this city , average services per provider: 15. This provider delivers 2.1× the peer median.Open Payments
Industry payments received
All-time total
$125
Transactions
6
Manufacturers
4
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| GENZYME CORPORATION | 2 | $46.42 | |
| Regeneron Healthcare Solutions, Inc. | 2 | $37.80 | |
| Vifor Pharma, Inc. | 1 | $26.30 | |
| Mylan Specialty L.P. | 1 | $14.52 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
13
Patients
13
Total drug cost
$112
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Amoxicillin-Clavulanate Potass (Amoxicillin/Potassium Clav) | Brand | 13 | 13 | $112 |