Larry C. Mack-Wilson, P.A.
NPI 1235413667ActiveIndividual· Physician Assistant, Medical· Reston, VA
Physician Assistant, Medical (P.A.) with Privia Medical Group, LLC, practicing in Reston, Virginia. Mostly services rather than prescriptions: Medicare paid $4,582 for 46 patients in 2024, with only 32 Part D claims. Lists Virginia Hospital Center as a hospital affiliation.
Overview
| NPI | 1235413667 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | P.A. |
| Sole proprietor | No |
| NPI issued | Oct 4, 2011 |
| Last updated in NPPES | Oct 4, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | 0110003693 | VA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (DC); Practitioner - Physician Assistant (VA); Practitioner - Physician Assistant (WV) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 46 |
|---|---|
| Services billed | 92 across 14 procedure codes |
| Paid by Medicare | $4,582 |
Part D prescriptions in 2024
| Prescriptions (claims) | 32 · 33 30-day fills |
|---|---|
| Patients | 21 |
| Total drug cost | $361.84 |
| Generic share | 84% of claims |
Education and affiliations
| Graduation year | 2011 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Privia Medical Group, LLCFairfax, VA · 1,533 clinicians
Hospital affiliation
- Virginia Hospital CenterArlington, VA
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 21 physician assistants in Reston · All physician assistants in Virginia