Michael Wild, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

7546357-1205 Issued in UT

Practice address

220 Millpond Ste 100
Stansbury Park, UT 84074-9760

Phone

(435) 843-3000

Fax

(435) 843-3015

NPI assigned

Sep 25, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, UT, ND, NV, CA5 enrollments

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 5

Specialty

Family Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University of Utah Community Physicians GroupGroup PAC ID 9739403569, 277 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Canyon Home Care Home health agency, Murray, UT, CCN 467226
• Harmony Home Health Home health agency, Murray, UT, CCN 467104
• Rocky Mountain Home Health - Utah Home health agency, Woods Cross, UT, CCN 467061
• University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009
• Mountain West Medical Center Hospital, Tooele, UT, CCN 460014

Merit-based Incentive Payment System (MIPS)

Final score

89.01 of 100Reported as group

Quality

94.06

Promoting interoperability

100

Improvement activities

40

Cost

69.32

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mlandis415607@direct.med.utah.edu

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 Utah Community Physicians Group

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1467241554
  Medicare reassignment Care Compare group
• Quentin N Burdick Comprehensive Health Care Facility

  • Rural Acute Care Hospital
  • Belcourt, ND
  • NPI 1952346934

  TX

  Medicare reassignment NPD
• Signify Health Medical Associates of California, PC

  • General Practice Physician
  • San Francisco, CA
  • NPI 1124685169
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  ND, NV

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  UT

  Medicare reassignment NPD
• Health Evolution Solutions

  • General Practice Physician
  • Herriman, UT
  • NPI 1871208546

  Family Medicine

  NPD Authorized official
• University of Utah Community Physicians Group

  • Family Medicine Physician
  • Park City, UT
  • NPI 1053715763
  NPD
• University of Utah Community Physicians Group

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1124422126
  NPD
• University of Utah Community Physicians Group

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1730583444
  NPD

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

• Harmony Home Health Services, LLC

  • Home Health Agency
  • Murray, UT
  • NPI 1184770547
  Care Compare affiliation
• Home Caregivers Partnership, LLC

  • Home Health Agency
  • Murray, UT
  • NPI 1306899265
  Care Compare affiliation
• Rmce Utah Home Health and Hospice LLC

  • Home Health Agency
  • Woods Cross, UT
  • NPI 1225914138
  Care Compare affiliation
• Tooele Hospital Corporation

  • General Acute Care Hospital
  • Tooele, UT
  • NPI 1124090659
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1487734976
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1588656870
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1699889576
  Care Compare affiliation

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700697600000",
    "number": "1225689748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 MILLPOND STE 100",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "840749760",
            "telephone_number": "435-843-3000",
            "fax_number": "435-843-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 MILLPOND STE 100",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "840749760",
            "telephone_number": "435-843-3000",
            "fax_number": "435-843-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-25",
        "last_updated": "2023-11-23",
        "certification_date": "2023-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "RL16538",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "UT",
            "license": "7546357-1205",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "7546357-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlandis415607@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brooke Vantoorenburg, DMD
• Jamison Jenkins Wagner, DDS
• Adam Webster, PHARMD
• Dale Eugene Werner, LCSW
• Harley Jo Whitesides
• Wisdom Teeth Centers LLC
• Fei Yue Zhang, RPH

• Family Medicine Physician in Stansbury Park, UT
• Providers in Stansbury Park, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2023; 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.
• 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.