Robert S. Wildin, MD

Primary specialty

Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X

License

042-0013813 Issued in VT

Practice address

111 Colchester Ave
Burlington, VT 05401-1473

Phone

(802) 847-0000

NPI assigned

Feb 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rwildin176793@direct.uvmhealth.org

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.

• University of Vermont Medical Center Inc

  • Internal Medicine Physician
  • Burlington, VT
  • NPI 1659309615
  Medicare reassignment NPD
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1447299342
  NPD (past)
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1073586897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1063",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054021063",
            "telephone_number": "802-847-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDIN",
        "first_name": "ROBERT",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "OR",
            "license": "MD20420",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "VT",
            "license": "042-0013813",
            "primary": true
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "ID",
            "license": "M8801",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8140428",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002823400",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085514",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clayton Ross Wilburn, M.D.
• Rebecca L Wilcox, M.D.
• Katherine E. Wilde, MSN, FNP-C, PMHNP-BC
• Morgaine Wilde, MSW
• Wildflower Counseling & Consulting LLC
• Rhiannon Chou Wiley, PHD
• Robert Wilkey
• Tonya Wilkinson, RN, MSN, CPNP
• Willard Street Family Dental
• Saja Willard, MA

• Clinical Genetics (M.D.) Physician in Burlington, VT
• Providers in Burlington, VT by specialty
• Clinical Genetics (M.D.) Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.