Jonathan Michael Wildy, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

3906 Issued in CA

Practice address

5101 W 73Rd St
Prairie Village, KS 66208-2434

Phone

(619) 600-1023

NPI assigned

Jun 16, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pine Ridge Indian Health Service HospitalGroup PAC ID 4688571326, 107 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

78.15 of 100Reported as group

Quality

74.3

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Pine Ridge Indian Health Service Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment Care Compare group NPD
• MCH Professional Care Hospital Based

  • Family Medicine Physician
  • Odessa, TX
  • NPI 1447547773
  Medicare reassignment NPD
• Medstream Anesthesia PLLC

  • Anesthesiology Physician
  • Richardson, TX
  • NPI 1649616160

  Nurse Anesthetist, Certified Registered

  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Martin, SD
  • NPI 1003208257
  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518
  NPD
• Turlock Anesthesia Medical Group Inc

  • Anesthesiology Physician
  • Turlock, CA
  • NPI 1275835605

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1619137288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 W 73RD ST",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662082434",
            "telephone_number": "619-600-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 W 73RD ST",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662082434",
            "telephone_number": "619-600-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDY",
        "first_name": "JONATHAN",
        "middle_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "1390081012",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "3906",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024168911",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "556930",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas J Whittaker, M.D.
• Ashley Heintzelman Wiedenmeyer, PHD
• Kristin Wier, DPT
• Kate R Wildeman Nievar, DPT
• Giselle Wildman, DO
• Janna Leigh Willhaus, ARNP
• Anna Zoe Williams, MS, CCC-SLP
• Heidi Annette Williams, PHARMD
• Jessica Williams
• Phillip Williams

• Certified Registered Nurse Anesthetist in Prairie Village, KS
• Providers in Prairie Village, KS by specialty
• Certified Registered Nurse Anesthetist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.