Kadin Gabriel Wiley

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA211370 Issued in OR

Practice address

638 Market St
Medford, OR 97504-6126

Phone

(541) 535-6239

NPI assigned

May 22, 2020

Sex

Male

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 OR, AZ2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Clinica del Valle Family Health Care Center IncGroup PAC ID 0244143089, 59 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• La Clinica del Valle Family Health Care Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Medford, OR
  • NPI 1851327571
  Medicare reassignment Care Compare group NPD
• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1609300854
  Medicare reassignment NPD (past)
• Valley Immediate Care, LLC

  • Urgent Care Clinic/Center
  • Medford, OR
  • NPI 1982709226
  Medicare reassignment
• La Clinica del Valle Family Health Care Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Medford, OR
  • NPI 1679896278
  NPD
• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1316777956
  NPD
• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1700668795
  NPD
• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Peoria, AZ
  • NPI 1740079060
  NPD
• Valley Immediate Care, LLC

  • Non-Pharmacy Dispensing Site
  • Grants Pass, OR
  • NPI 1821504192
  NPD (past)
• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1710283593
  NPD (past)

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1245853373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127",
            "telephone_number": "541-535-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 MARKET ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046126",
            "telephone_number": "541-535-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "KADIN",
        "middle_name": "GABRIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-22",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10701",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA211370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Kay Wilder, LCSW
• Carol Jean Wilder, MD
• Mary S Wilder, RN
• Jason Ward Wileman, BS, QMHA
• Mali Wileman
• William Kurt Wilkening, O. D.
• Aalexyz Mychelle Wilkinson, LMT
• George R Wilkinson, MD
• Jessica Elizabeth Willard, HAS
• Nathan Alexander Willard

• Physician Assistant in Medford, OR
• Providers in Medford, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.