NPIMap

Individual provider Active NPI

Brandon J Wilding, M.D.

  • Emergency Medicine Physician
  • Boise, ID
National Provider Identifier
1851307367
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD183623 Issued in OR
Practice address
1055 N Curtis Rd
Boise, ID 83706-1309
Phone
(208) 322-1730
Fax
(208) 322-1731
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X M9611 ID
Emergency Medicine Physician 207P00000X MD183623 OR Primary

Addresses

Primary practice location

1055 N Curtis Rd
Boise, ID 83706-1309

Mailing address

2963 E Copper Point Dr
Suite 150
Meridian, ID 83642-9055
Phone (208) 322-1730

Other practice location 1

3325 Pocahontas Rd
Baker City, OR 97814-1464
Phone (514) 523-1797

Other identifiers 1

IdentifierTypeStateIssuer
807513600MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061023000235 ID Practitioner - Emergency Medicine 8921005661 Reassigns benefits to 1 organization
I20171013002046 OR Practitioner - Emergency Medicine 8921005661 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, shared by 18 NPIs, 995 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

2801 St Anthony Way
Pendleton, OR 97801-3800
Phone (541) 276-5121

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013
  • Saint Alphonsus Medical Center Ontario Hospital, Ontario, OR, CCN 380052
  • St. Alphonsus Medical Center - Baker City Hospital, Baker City, OR, CCN 381315
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M9611IDMDEmergency Medicine Physician
MD183623ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America, LLC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Saint Alphonsus Medical Center Baker City, Inc CurrentSince Oct 1, 2022 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Oct 3, 2017 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Saint Alphonsus Medical Center Baker City, Inc Family Medicine CurrentSince Oct 1, 2022 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

1512 12th Ave Rd
Nampa, ID 83686
Phone (208) 463-5000

3325 Pocahontas Rd
Baker City, OR 97814
Phone (541) 523-1797

2801 St Anthony Way
Pendleton, OR 97801
Phone (541) 276-5121

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

Interoperability endpoints

  • Direct secure messaging: bwilding1563459@direct.trinity-health.org

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 10

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1851307367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2963 E COPPER POINT DR",
            "address_2": "SUITE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429055",
            "telephone_number": "208-322-1730",
            "fax_number": "208-322-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061309",
            "telephone_number": "208-322-1730",
            "fax_number": "208-322-1731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3325 Pocahontas Rd",
            "address_purpose": "LOCATION",
            "city": "Baker City",
            "state": "OR",
            "postal_code": "978141464",
            "country_code": "US",
            "telephone_number": "514-523-1797",
            "fax_number": "514-523-1799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDING",
        "first_name": "BRANDON",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M9611",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD183623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807513600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.