Venis Tiarra Wilder, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

139734 Issued in FL

Practice address

180 SW 84TH Ave
Plantation, FL 33324-2731

Phone

(954) 945-3510

NPI assigned

Apr 30, 2010

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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 Practice

Education

Harvard Medical School, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: venis.wilder@wwmp.eclinicaldirectplus.com

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.

• Guidewell Sanitas I, LLC

  dba Clinisanitas

  • Family Medicine Physician
  • Doral, FL
  • NPI 1396124046
  NPD

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1396062287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 NW 33RD ST STE 201",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331221937",
            "telephone_number": "786-408-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 SW 84TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242731",
            "telephone_number": "954-945-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "VENIS",
        "middle_name": "TIARRA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "263649",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "139734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03716332",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Widner, MD
• Ernestine Wielandt
• Martin Saul Wiesenthal, O.D.
• Wiggins & Wheeler
• Lina Maria Wilches-Karrat, PMHNP-BC
• Wildflower Telehealth Network Inc.
• Abby Eileen Wilentz, DMD
• Wilfred C McKenzie PA
• Alecia Petrenia Williams, CRNA
• Chanique Williams

• Family Medicine Physician in Plantation, FL
• Providers in Plantation, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.