Active NPI
Trisha J Wilder, PA-C
- Medical Physician Assistant
- Bend, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA21676
- Practice address
- 61250 SE Coombs PL
Bend, OR 97702-3704 - Phone
- (541) 706-5930
- Fax
- (541) 706-5931
- NPI assigned
- Jul 26, 2011
- Last updated
- Dec 3, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA21676 | CA | Primary |
Addresses
Primary practice location
61250 SE Coombs PL
Bend, OR 97702-3704
Mailing address
1236 NW Baltimore Ave
Bend, OR 97703-3125
Phone (530) 526-3218
Other practice location 1
1742 Oregon St
Redding, CA 96001-1717
Phone (530) 526-3218
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | twilder199089@secure.stcharleshealthcare.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of California, Davis School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
211 NW Larch Ave
Family Care
Redmond, OR 97756-1357
Phone (541) 548-2164
51781 Huntington Rd
La Pine, OR 97739-1118
Phone (541) 666-7920
61250 SE Coombs PL
Family Care Clin
Bend, OR 97702-3704
Phone (541) 706-5935
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA21676 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| Icco LLC | Current | Accepting new patients | |
| Icco, LLC | Current | Accepting new patients | |
| Cep America - California | Current | Accepting new patients | |
| Cep America-California | Current | Accepting new patients | |
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| Apogee Outpatient Surgery Center | Past | Accepting new patients | |
| Rainbow Basin Emergency Physicians, a Medical Corporation | Past | Accepting new patients | |
| Premier Emergency Physicians of California Medical Group PC | Past | Accepting new patients | |
| St. Charles Health System, Inc. | Past | Accepting new patients |
Locations
800 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-8511
1205 E North St
Manteca, CA 95336
Phone (209) 239-8301
726 4th St
Marysville, CA 95901
Phone (530) 491-9491
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663
825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744
29358 Network Pl
Chicago, IL 60673
61250 SE Coombs Pl
Bend, OR 97702
Phone (541) 706-5930
598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473
3675 Pacific Ave
#101
Forest Grove, OR 97116
Phone (971) 762-4611
1890 NW 6th St
Grants Pass, OR 97526
Phone (541) 507-0684
3737 Shasta Way
Ste A
Klamath Falls, OR 97603
Phone (541) 883-2337
3400 Cooperative Way
Lebanon, OR 97355
Phone (541) 333-6605
384 SE Combs Flat Rd
Prineville, OR 97754
Phone (541) 383-3668
211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164
3818 SW 21st St
Ste 100
Redmond, OR 97756
Phone (541) 548-2899
Organizations & group practices 12
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.
-
dba St. Charles Medical Group
- Family Medicine Physician
- Bend, OR
- NPI 1023331303
-
dba North American Mental Health Services
- Psychiatry Physician
- Redding, CA
- NPI 1073919171
-
dba The Center at St. Charles Medical Equipment
- Specialist
- Bend, OR
- NPI 1700697935
-
- Emergency Medicine Physician
- Murrieta, CA
- NPI 1588552848
-
dba St. Charles Medical Supply - Redmond
- Oxygen Equipment & Supplies (DME)
- Redmond, OR
- NPI 1427140870
-
- Ambulatory Surgical Clinic/Center
- Redding, CA
- NPI 1912094509
-
- Emergency Medicine Physician
- Barstow, CA
- NPI 1225289135
-
- Emergency Medicine Physician
- Barstow, CA
- NPI 1811148729
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba NW High Desert Sleep Center Bend
- Sleep Disorder Diagnostic Clinic/Center
- Bend, OR
- NPI 1164675963
Hospital
-
dba St. Charles Prineville
- Critical Access Hospital
- Prineville, OR
- NPI 1710160445
-
dba St. Charles Bend
- General Acute Care Hospital
- Bend, OR
- NPI 1982621447
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733184000000",
"number": "1609154517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1236 NW BALTIMORE AVE",
"city": "BEND",
"state": "OR",
"postal_code": "977033125",
"telephone_number": "530-526-3218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61250 SE COOMBS PL",
"city": "BEND",
"state": "OR",
"postal_code": "977023704",
"telephone_number": "541-706-5930",
"fax_number": "541-706-5931"
}
],
"practiceLocations": [
{
"address_1": "1742 Oregon St",
"address_purpose": "LOCATION",
"city": "Redding",
"state": "CA",
"postal_code": "960011717",
"country_code": "US",
"telephone_number": "530-526-3218",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILDER",
"first_name": "TRISHA",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-26",
"last_updated": "2024-12-03",
"certification_date": "2024-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA21676",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "twilder199089@secure.stcharleshealthcare.org",
"affiliation": "N",
"address_1": "61250 SE Coombs Pl",
"city": "Bend",
"state": "OR",
"country_code": "US",
"postal_code": "977023704",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.