Individual provider Active NPI

Hope A Wildenberg, M.D.

  • Family Medicine Physician
  • Ridgecrest, CA
National Provider Identifier
1912900739
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G83457 Issued in CO
Practice address
105 E Sydnor Ave Ste 100
Ridgecrest, CA 93555-5546
Phone
(760) 446-6404
Fax
(760) 446-6415
NPI assigned
May 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G83457 CO Primary

Addresses

Primary practice location

105 E Sydnor Ave Ste 100
Ridgecrest, CA 93555-5546

Mailing address

1081 N China Lake Blvd
Ridgecrest, CA 93555-3130
Phone (760) 446-6404

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hopewildenberg@rrh.medalliesdirect.net Direct

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
I20060725000483 CA Practitioner - Family Practice 6507879236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ridgecrest Regional HospitalGroup PAC ID 9739099896, 94 clinicians

Practice addresses (Care Compare)

105 E Sydnor Ave
Suite 100
Ridgecrest, CA 93555-5546
Phone (760) 446-6404

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G83457COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgecrest Regional Hospital CurrentSince Jun 22, 2013 Accepting new patients
Ridgecrest Regional Hospital Family Medicine Past Accepting new patients

Locations

1111 N China Lake Blvd
#190
Ridgecrest, CA 93555
Phone (760) 499-3855

105 E Sydnor Ave
Ridgecrest, CA 93555

1011 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 499-3360

1041 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0121

1041 N China Lake Blvd
Ste B
Ridgecrest, CA 93555
Phone (760) 446-6404

105 E Sydnor Ave
Ste 100
Ridgecrest, CA 93555
Phone (760) 446-6404

1081 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0616

1011 N China Lake Blvd
Ste B
Ridgecrest, CA 93555
Phone (661) 726-5005

82820 Trona Rd
Trona, CA 93562
Phone (760) 372-4524

Interoperability endpoints

  • Direct secure messaging: hopewildenberg@rrh.medalliesdirect.net

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.

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1912900739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 N CHINA LAKE BLVD",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935553130",
            "telephone_number": "760-446-6404",
            "fax_number": "760-446-6415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E SYDNOR AVE STE 100",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935555546",
            "telephone_number": "760-446-6404",
            "fax_number": "760-446-6415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDENBERG",
        "first_name": "HOPE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "G83457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hopewildenberg@rrh.medalliesdirect.net",
            "affiliation": "N",
            "endpointDescription": "RRH Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "105 E Sydnor Ave Ste 100",
            "city": "Ridgecrest",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935555546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ridgecrest, CA

Sources for this page

Verify at the official NPI Registry.