Richard Alan Wilde, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME82294 Issued in FL

Practice address

1854 Oak Grove Blvd
Lutz, FL 33559-8605

Phone

(813) 948-6133

Fax

(813) 948-3460

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

No

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.

• Pediatric Health Care Alliance, PA

  • Pediatrics Physician
  • Lutz, FL
  • NPI 1619643566

  Pediatrics

  NPD
• Pediatric Health Care Alliance, PA

  • Pediatrics Physician
  • Oldsmar, FL
  • NPI 1609965441

  Pediatrics

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 11, 2021.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1912923830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 TAMPA RD",
            "address_2": "STE 101",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346773224",
            "telephone_number": "813-854-2003",
            "fax_number": "813-855-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1854 OAK GROVE BLVD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335598605",
            "telephone_number": "813-948-6133",
            "fax_number": "813-948-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "RICHARD",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME82294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262370600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Monique Whitley, LCSW
• Amanda Whitman, PHARMD, CPH
• Danielle Jean Whittington, LCSW
• Lindsay Wiberly, MSN, APRN, FNP-BC
• Karen Marie Wilcox, P.A.-C
• Angel Wildgoose
• Willett Collections, LLC
• David Willey, MD
• William J Geyer DDS, PA
• William T Trabulsi DPM PA

• All providers in Lutz, FL
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.