NPIMap

Individual provider Active NPI

Trevor T Wild, M.D.

  • Urology Physician
  • Clive, IA
National Provider Identifier
1881969111
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD-44953 Issued in IA
Practice address
12129 University Ave Ste 100
Clive, IA 50325-8298
Phone
(513) 400-3550
NPI assigned
Mar 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Urology Physician 208800000X DR.0062223 CO
Urology Physician 208800000X MD-44953 IA Primary

Addresses

Primary practice location

12129 University Ave Ste 100
Clive, IA 50325-8298

Mailing address

12129 University Ave Ste 200
Clive, IA 50325-8298
Phone (515) 400-3550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180718002372 IA Practitioner - Urology 9830419845 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Iowa, RJ & L Carver College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urology Center of Iowa PLLCGroup PAC ID 1658701834, 32 clinicians
Grinnell Regional Medical CenterGroup PAC ID 0446153662, 98 clinicians
Broadlawns Medical CenterGroup PAC ID 3678466166, 302 clinicians
Pella Regional Health CenterGroup PAC ID 9931005873, shared by 10 NPIs, 96 clinicians

Practice addresses (Care Compare)

12129 University Ave
Clive, IA 50325-8287
Phone (515) 400-3550

122 4TH Ave
Grinnell, IA 50112-1829
Phone (641) 236-4323

1660 60TH St
West Des Moines, IA 50266-7700
Phone (515) 343-1000

1755 59TH PL
West Des Moines, IA 50266-7737
Phone (515) 358-8000

1801 Hickman Rd
Des Moines, IA 50314-1548
Phone (515) 282-2200

405 Monroe St
Pella, IA 50219-1189
Phone (641) 628-3832

700 E Uinversity Ave
Des Moines, IA 50316-2302
Phone (515) 263-5612

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-44953IAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Broadlawns Medical Center CurrentSince Apr 15, 2019 Accepting new patients
Pella Regional Health Center CurrentSince May 1, 2022 Accepting new patients
Surgery Centers of Iowa LLC Current Accepting new patients
Greene County Medical Center CurrentSince Oct 13, 2021 Accepting new patients
Cass County Memorial Hospital Current Accepting new patients
Pella Regional Health Center Current Accepting new patients
The Iowa Clinic PC Urology CurrentSince Aug 20, 2018 Accepting new patients
Greene County Medical Center CurrentSince Oct 13, 2021 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
The Iowa Clinic, PC CurrentSince Aug 20, 2018 Accepting new patients
Broadlawns Medical Center CurrentSince Apr 15, 2019 Accepting new patients
Pella Regional Health Center CurrentSince May 1, 2022 Accepting new patients
Greene County Medical Center Current Accepting new patients
Urology Center of Iowa PLLC Urology CurrentSince Mar 1, 2020 Accepting new patients
Cass County Memorial Hospital CurrentSince Jul 1, 2025 Accepting new patients
Cass County Memorial Hospital CurrentSince Jul 1, 2025 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
Urology Partners of North Texas, PLLC Urology PastSince Mar 3, 2024 Accepting new patients

Locations

1501 E 10th St
Atlantic, IA 50022
Phone (712) 243-2850

12129 University Ave
Ste 100
Clive, IA 50325
Phone (515) 400-3550

12129 University Ave
Ste 200
Clive, IA 50325

12129 University Ave
Clive, IA 50325
Phone (515) 400-3550

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

1801 Hickman Rd
Bldg First
Des Moines, IA 50314

122 4th Ave
Grinnell, IA 50112
Phone (641) 236-4323

1000 W Lincoln Way
Jefferson, IA 50129
Phone (515) 386-2114

1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589

405 Monroe St
Pella, IA 50219
Phone (641) 621-2200

Interoperability endpoints

  • Direct secure messaging: wild.trevor@cynchealthdsm.org
  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10390883
  • FHIR API: https://fhir-myrecord.cerner.com/r4/18f5d65c-83f0-435a-868c-70ce5a6de90a/
  • Direct secure messaging: twild631979@direct.unitypoint.org
  • Direct secure messaging: trevorwild@uciwa.allscriptsdirect.net

Organizations & group practices 19

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.

View all 19

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": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1881969111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12129 UNIVERSITY AVE STE 200",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258298",
            "telephone_number": "515-400-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12129 UNIVERSITY AVE STE 100",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258298",
            "telephone_number": "513-400-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "TREVOR",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-20",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CO",
            "license": "DR.0062223",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IA",
            "license": "MD-44953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.