Individual provider Active NPI

Tyler John Wildes, MD, PHD

  • Anatomic Pathology & Clinical Pathology Physician
  • Savannah, GA
National Provider Identifier
1033797626
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
101421 Issued in GA
Practice address
5353 Reynolds St
Savannah, GA 31405-6015
Phone
(800) 288-8325
NPI assigned
Apr 1, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 101421 GA Primary

Addresses

Primary practice location

5353 Reynolds St
Savannah, GA 31405-6015

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250812003287 GA Practitioner - Pathology 3577965177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Florida College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chatham Pathology Associates PCGroup PAC ID 6204823826, 6 clinicians

Practice addresses (Care Compare)

5353 Reynolds St
Savannah, GA 31405-6015
Phone (800) 528-3448

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Chatham Pathology Associates PC Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 2025 Accepting new patients

Locations

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

5700 Southwyck Blvd
Toledo, OH 43614

Organizations & group practices 1

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 2

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": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1033797626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 REYNOLDS ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056015",
            "telephone_number": "800-288-8325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDES",
        "first_name": "TYLER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "101421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.