Individual provider Active NPI

David Stephen Wilgarde, M.D.

  • Pain Medicine Physician
  • Palm Springs, CA
National Provider Identifier
1790785467
Registry record updated Jun 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
G74463 Issued in CA
Practice address
3001 E Tahquitz Canyon Way Ste 108
Palm Springs, CA 92262-6900
Phone
(760) 320-4292
Fax
(760) 322-9475
NPI assigned
Jul 26, 2005
Reactivated
Mar 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X G744630
Pain Medicine Physician 208VP0000X G74463 CA Primary

Addresses

Primary practice location

3001 E Tahquitz Canyon Way Ste 108
Palm Springs, CA 92262-6900

Mailing address

148 W Camino Encanto
Palm Springs, CA 92264-8910
Phone (760) 969-5200

Other identifiers 1

IdentifierTypeStateIssuer
00G744632MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040511000789 CA Practitioner - Other (Physician)Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 7214926567 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Undefined Physician Type (Specify)Also: Pain Management, Physical Medicine and Rehabilitation
Education
Wayne State University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Choice Physician PartnersGroup PAC ID 0941465322, 130 clinicians

Practice addresses (Care Compare)

1150 M Indian Canyon Dr
Palm Springs, CA 92262-4872
Phone (760) 323-6511

3001 E Tahquitz Canyon Way
Suite 108
Palm Springs, CA 92262-6900
Phone (760) 320-4292

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Physician Partners CurrentSince Oct 18, 2024 Accepting new patients
First Choice Physician Partners CurrentSince Oct 18, 2024 Accepting new patients
First Choice Physician Partners Current Accepting new patients
Diagnostic Imaging Services Past Accepting new patients
Eisenhower Medical Center Past Accepting new patients

Locations

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

35800 Bob Hope Dr
Ste 225
Rancho Mirage, CA 92270
Phone (760) 324-4466

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717286400000",
    "number": "1790785467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 W CAMINO ENCANTO",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922648910",
            "telephone_number": "760-969-5200",
            "fax_number": "760-969-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 E TAHQUITZ CANYON WAY STE 108",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626900",
            "telephone_number": "760-320-4292",
            "fax_number": "760-322-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILGARDE",
        "first_name": "DAVID",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2024-06-02",
        "certification_date": "2024-06-02",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": "G744630",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "G74463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G744632",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.