NPIMap

Individual provider Active NPI

Janet Lynn Wildemuth, PA

  • Physician Assistant
  • Gilbert, AZ
National Provider Identifier
1588915003
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5183 Issued in AZ
Practice address
1489 S Higley Rd
Suite #101
Gilbert, AZ 85296-4776
Phone
(480) 457-8800
Fax
(480) 457-8885
NPI assigned
Sep 24, 2012
Last updated
Dec 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5183 AZ Primary
Family Medicine Physician 207Q00000X 5183 AZ

Addresses

Primary practice location

1489 S Higley Rd
Suite #101
Gilbert, AZ 85296-4776

Mailing address

1489 S Higley Rd
Suite #101
Gilbert, AZ 85296-4776
Phone (480) 457-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121221000031 AZ Practitioner - Physician Assistant 6406008473 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19829 N 27TH Ave
Phoenix, AZ 85027-4001
Phone (623) 879-6100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.59 of 100Reported as group
Quality
81.55
Promoting interoperability
100
Improvement activities
40
Cost
79.5

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5183AZMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Aug 1, 2019 Accepting new patients
Vituity - Arizona Hospitalists PC CurrentSince Jun 1, 2023 Accepting new patients
District Medical Group, Inc CurrentSince Aug 1, 2019 Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Tri-City Express Care, PLLC Family Medicine Past Accepting new patients
Tri-City Express Care, PLLC Family Medicine Past Accepting new patients
Honorhealth Urgent Care, LLC Family Medicine Past Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Tri-City Express Care, PLLC Family Medicine Past Accepting new patients

Locations

19829 N 27th Ave
Phoenix, AZ 85027
Phone (602) 879-5720

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

33400 N 32nd Ave
Phoenix, AZ 85085
Phone (540) 998-0000

5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

Interoperability endpoints

  • Direct secure messaging: jwildemuth211400@direct.valleywisehealth.org

Organizations & group practices 10

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1588915003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1489 S HIGLEY RD",
            "address_2": "SUITE #101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964776",
            "telephone_number": "480-457-8800",
            "fax_number": "480-457-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1489 S HIGLEY RD",
            "address_2": "SUITE #101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964776",
            "telephone_number": "480-457-8800",
            "fax_number": "480-457-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDEMUTH",
        "first_name": "JANET",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5183",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "5183",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.