Brianna Carolyn Wilder, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

14546 Issued in MN

Practice address

830 Prairie Center Dr
Eden Prairie, MN 55344-7301

Phone

(952) 826-6500

NPI assigned

Feb 12, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fairview Clinics

  dba Fairview Clinics-Hiawatha

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment Care Compare group
• Mayo Clinic

  • Multi-Specialty Clinic/Center
  • Rochester, MN
  • NPI 1922074434
  Medicare reassignment
• Fairview Clinics

  dba Fairview Clinics-Eden Prairie

  • Primary Care Clinic/Center
  • Eden Prairie, MN
  • NPI 1336331297
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Mayo Clinic

  • Medical Specialty Clinic/Center
  • Rochester, MN
  • NPI 1427235068
  NPD

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

{
    "created_epoch": "1644624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1225783897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 PRAIRIE CENTER DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447301",
            "telephone_number": "952-826-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E 28th St Ste H2100",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554073723",
            "country_code": "US",
            "telephone_number": "612-863-3900",
            "fax_number": "612-775-3199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 1st Street SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDER",
        "first_name": "BRIANNA",
        "middle_name": "CAROLYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-12",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14546",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kris Carl Wicklund I, LMFT, LADC
• James Frederick Wiedenhoefer, MD
• Mitchell Lee Wiggins Jr.
• Melissa Sue Wilcowski, CMT, NCBTMB
• Justin Richard Wild, D.D.S.
• Keely Wilkie
• Kyle Wilkinson, PHARM.D
• Cassidy Williams
• Jessica Anne Williams
• Kathleen Renee Williams, DC

• Physician Assistant in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.