Jeffrey Virgil Wilde, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

44157 Issued in AZ

Practice address

302 El Camino Real BLDG 11
Sierra Vista, AZ 85635-2860

Phone

(520) 255-5475

Fax

(855) 801-7998

NPI assigned

Aug 1, 2007

Last updated

Mar 18, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Family PracticeAlso: Obstetrics/Gynecology

Education

Eastern Virginia Medical School, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jeffrey Wilde MD PLLCGroup PAC ID 6901138049, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayada Home Health Care, Inc Home health agency, Sierra Vista, AZ, CCN 037416
• Haven Home Health Care Home health agency, Tucson, AZ, CCN 037494
• Valor Hospice Hospice, Sierra Vista, AZ, CCN 031586
• Canyon Vista Medical Center Hospital, Sierra Vista, AZ, CCN 030043
• Tucson Medical Center Hospital, Tucson, AZ, CCN 030006
• Life Care Center of Sierra Vista Nursing home, Sierra Vista, AZ, CCN 035136

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeffrey.wilde.1@20478.direct.athenahealth.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Jeffrey Wilde MD PLLC

  • Rural Health Clinic/Center
  • Sierra Vista, AZ
  • NPI 1467335737

  5% Or Greater Direct Ownership Interest, W-2 Managing Employee

  CMS ownership

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

• Jeffrey Wilde MD PLLC

  dba Wilde Desert Family Medicine

  • Family Medicine Physician
  • Sierra Vista, AZ
  • NPI 1518515683
  Medicare reassignment Care Compare group NPD Authorized official
• Jeffrey Wilde MD PLLC

  • Rural Health Clinic/Center
  • Sierra Vista, AZ
  • NPI 1467335737

  Family Medicine

  NPD
• Joe a. Santos, Acsw, LCSW, PLLC

  • Clinical Social Worker
  • Sierra Vista, AZ
  • NPI 1326496233
  NPD (past)

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

• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Sierra Vista, AZ
  • NPI 1912291139
  Care Compare affiliation
• Home Health Tucson, LLC

  dba Choice Health at Home

  • Home Health Agency
  • Tucson, AZ
  • NPI 1407323884
  Care Compare affiliation
• Huachuca Healthcare, LLC

  dba Valor Hospice

  • Community Based Hospice Care Agency
  • Sierra Vista, AZ
  • NPI 1447931134
  Care Compare affiliation
• RCHP-Sierra Vista Inc

  dba Sonoita Family Health

  • Rural Health Clinic/Center
  • Sonoita, AZ
  • NPI 1013160290

  Hospital

  Care Compare affiliation
• RCHP-Sierra Vista Inc

  dba Canyon Vista Medical Center

  • General Acute Care Hospital
  • Sierra Vista, AZ
  • NPI 1194766543
  Care Compare affiliation
• RCHP-Sierra Vista Inc

  dba Tombstone Family Health

  • Rural Health Clinic/Center
  • Tombstone, AZ
  • NPI 1508010471

  Hospital

  Care Compare affiliation
• Sierra Vista Medical Investors, LP

  dba Life Care Center of Sierra Vista

  • Skilled Nursing Facility
  • Sierra Vista, AZ
  • NPI 1124066188

  Nursing home

  Care Compare affiliation
• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792
  Care Compare affiliation

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1073703310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 EL CAMINO REAL BLDG 11",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352860",
            "telephone_number": "520-255-5475",
            "fax_number": "855-801-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 EL CAMINO REAL BLDG 11",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352860",
            "telephone_number": "520-255-5475",
            "fax_number": "855-801-7998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2585 E Wilcox Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Sierra Vista",
            "state": "AZ",
            "postal_code": "856352822",
            "country_code": "US",
            "telephone_number": "520-255-5475",
            "fax_number": "855-801-7998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDE",
        "first_name": "JEFFREY",
        "middle_name": "VIRGIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "44157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "613078",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle White, FNP-C
• Larry L White, PT
• Rachael Suzanne Whiteside, RN
• Priscilla D Whitlock-Coates, LPC
• Susan Wigetman, CRNA
• Todd Wilde, DPT
• Ineke Wilkin, RD
• Nicole Marie Willey
• Amy Williams, M. ED
• Nicole Lee Williams, RD

• Family Medicine Physician in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.