Active NPI
Terry T Wilsdorf, M.D.
- Cardiovascular Disease Physician
- Pensacola, FL
National Provider Identifier
1841236619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- ME142841
- Practice address
- 125 Baptist Way Ste 3a
Pensacola, FL 32503-2274 - Phone
- (448) 227-6604
- Fax
- (850) 857-1747
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 24078 | AL | |
| Cardiovascular Disease Physician | 207RC0000X | ME142841 | FL | Primary |
Addresses
Primary practice location
125 Baptist Way Ste 3a
Pensacola, FL 32503-2274
Mailing address
125 Baptist Way Ste 3a
Pensacola, FL 32503-2274
Phone (448) 227-6604
Other practice location 1
1700 Springhill Ave
Suite 100
Mobile, AL 36604-1407
Phone (251) 435-1200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104717100 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- University of Alabama School of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9570 US Hwy 90 200
Daphne, AL 36526
Phone (251) 625-8223
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24078 | AL | MD | Cardiovascular Disease Physician |
| ME142841 | FL | MD | Cardiovascular Disease Physician |
Interoperability endpoints
- twilsdorf193467@directinfirmaryhealth.org
- twilsdorf15797@directinfirmaryhealth.org
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Mobile, AL
- NPI 1447201066
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fairhope, AL
- NPI 1447303227
-
- General Acute Care Hospital
- Bay Minette, AL
- NPI 1134164924
-
- General Acute Care Hospital
- Mobile, AL
- NPI 1558364802
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710806400000",
"number": "1841236619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 BAPTIST WAY STE 3A",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325032274",
"telephone_number": "448-227-6604",
"fax_number": "850-857-1747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 BAPTIST WAY STE 3A",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325032274",
"telephone_number": "448-227-6604",
"fax_number": "850-857-1747"
}
],
"practiceLocations": [
{
"address_1": "1700 Springhill Ave",
"address_2": "Suite 100",
"address_purpose": "LOCATION",
"city": "Mobile",
"state": "AL",
"postal_code": "366041407",
"country_code": "US",
"telephone_number": "251-435-1200",
"fax_number": "251-435-6357",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSDORF",
"first_name": "TERRY",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2024-03-19",
"certification_date": "2024-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "AL",
"license": "24078",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "FL",
"license": "ME142841",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104717100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.