Olusegun Wilde, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

M3792 Issued in TX

Practice address

1600 Wallace Blvd
Amarillo, TX 79106-1799

Phone

(505) 894-2111

Fax

(505) 894-7659

NPI assigned

Apr 13, 2006

Last updated

Nov 1, 2013By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, OK2 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 2

Specialty

Emergency MedicineAlso: Family Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acs Primary Care Physicians Southwest PAGroup PAC ID 1850204363, 188 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as virtual group

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/fhir/r4
• Direct secure messaging: owilde355395@ahs.direct-ci.com

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.

• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  Medicare reassignment Care Compare group NPD
• Swiftcare Urgent Care, PLLC

  dba SwiftCare Urgent Care

  • Urgent Care Clinic/Center
  • Euless, TX
  • NPI 1578917340
  Medicare reassignment NPD
• Wise Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Decatur, TX
  • NPI 1366558264
  Medicare reassignment NPD
• Emergency Services of Oklahoma PC

  • Emergency Medicine Physician
  • Norman, OK
  • NPI 1215249891
  Medicare reassignment NPD
• Chandor Emergency Physicians

  • Emergency Medicine Physician
  • Weatherford, TX
  • NPI 1780872796
  NPD (past)
• Ellis Emergency Group PA

  • Emergency Medicine Physician
  • Ennis, TX
  • NPI 1497715239
  NPD (past)
• Howard Emergency Medicine Associates PA.

  • Nurse Practitioner
  • Big Spring, TX
  • NPI 1609972447

  Emergency Medicine

  NPD (past)
• KTX Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Wichita Falls, TX
  • NPI 1013194554
  NPD (past)
• PRMC Healthcare Group Inc

  • General Practice Physician
  • Paris, TX
  • NPI 1457514648

  Family Medicine

  NPD (past)
• Taylor Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Abilene, TX
  • NPI 1114987153
  NPD (past)
• United Primary Clinic Care LLC

  • Family Medicine Physician
  • Arlington, TX
  • NPI 1881419620
  NPD (past)
• Emergency Physicians at Sierra Vista

  • Emergency Medicine Physician
  • Truth Or Consequences, NM
  • NPI 1013966613
  NPD (past)

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

• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1467416727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840186",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840186",
            "telephone_number": "866-916-5259",
            "fax_number": "231-922-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061799",
            "telephone_number": "505-894-2111",
            "fax_number": "505-894-7659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "OLUSEGUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "M3792",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "20050127",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187155001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blaine Edward Wieck, DDS
• Richard Alan Wieners, LCDC
• Haley Wiggs
• Candace Stout Wike, LPC
• Daniel Wilbert
• David Wilhelm, MD
• Kara Leanne Wilhelm
• Jamie Wilkerson, MD
• Michael Dee Wilkerson, MD
• Eric Wilkie, D.D.S.

• Emergency Medicine Physician in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.