Tobias Allen Wilde Sr., MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24970 Issued in MN

Practice address

4422 30TH Ave S Apt 309
Fargo, ND 58104-8441

Phone

(801) 548-8535

NPI assigned

Sep 20, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Tobias Wilde Other name

Medicare fee-for-service enrollment

Enrolled in MN, ND2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, MN, ND

  Medicare reassignment NPD

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1770866485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 30TH AVE S APT 309",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048441",
            "telephone_number": "801-548-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 30TH AVE S APT 309",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048441",
            "telephone_number": "801-548-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "TOBIAS",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-20",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "5797",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOBIAS",
            "last_name": "WILDE",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Erika Wiger, DC
• Jeffrey Mark Wiisanen, MD
• Ronald E Wiisanen, MD
• Madisen Jean Wilander, MS,CCC-SLP
• Mackenzie Wild, MD
• Desiree Wildeman, OTR/L
• Benjiman Wilebski, MD,ATC
• Ross M Wilhelm, PHARMD
• Ashley Wilke, MD
• Joshua Wilke, MD

• Clinical Social Worker in Fargo, ND
• Providers in Fargo, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.

Verify at the official NPI Registry.