Individual provider Active NPI

Daniel E Wildes, D.O.

  • Cardiovascular Disease Physician
  • Tulsa, OK
National Provider Identifier
1932163565
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4168 Issued in OK
Practice address
717 S Houston Ave Ste 400
Tulsa, OK 74127-9007
Phone
(918) 582-7711
Fax
(918) 583-5831
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4168 OK Primary

Addresses

Primary practice location

717 S Houston Ave Ste 400
Tulsa, OK 74127-9007

Mailing address

5310 E 31St St Ste 13
Tulsa, OK 74135-5013
Phone (918) 561-5701

Other practice location 1

800 Kenyon Rd
Fort Dodge, IA 50501-5776
Phone (515) 574-6840

Other identifiers 2

IdentifierTypeStateIssuer
200031260BMedicaidOK
456078YM2YOtherOKMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040806000158 OK Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7113998071 Reassigns benefits to 2 organizations
I20240501000310 TX Practitioner - Cardiovascular Disease (Cardiology) 7113998071 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Creek Nation Hospital and ClinicsGroup PAC ID 5698786226, 364 clinicians
Pawnee Indian Health CenterGroup PAC ID 2769470160, 88 clinicians
Oklahoma State UniversityGroup PAC ID 2769739358, 110 clinicians

Practice addresses (Care Compare)

10109 E 79TH St
Tulsa, OK 74133-4564
Phone (918) 756-4333

1201 Heritage Cir
Pawnee, OK 74058-3744
Phone (918) 762-2517

1800 E Coplin St
Okemah, OK 74859-4642
Phone (918) 623-1424

2345 Southwest Blvd
Tulsa, OK 74107-2705
Phone (918) 561-5701

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.91 of 100Reported as group
Quality
77.78
Promoting interoperability
99
Improvement activities
40
Cost
73.95

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as group
Quality
83.76
Promoting interoperability
100
Improvement activities
40
Cost
56.64

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting19
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4168OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics CurrentSince Mar 10, 2024 Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients
Oklahoma State University CurrentSince Jan 1, 2020 Accepting new patients
Oklahoma State University Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Mar 10, 2024 Accepting new patients
Pawnee Indian Health Center CurrentSince Oct 1, 2025 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Mar 10, 2024 Accepting new patients
Oklahoma State University Medical Trust Past Accepting new patients
State of Oklahoma Past Accepting new patients
Iowa Heart Center PC Cardiovascular Disease Past Accepting new patients
Pawnee IHS Pharmacy PastSince Sep 21, 2025 Accepting new patients
Heart Care of Tulsa, Inc. Cardiovascular Disease Past Accepting new patients

Locations

309 N 14th St
Okemah, OK 74859
Phone (918) 623-1424

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1101 S Belmont Ave
Ste 204
Okmulgee, OK 74447
Phone (918) 756-3526

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

1201 Heritage Cir
Pawnee, OK 74058
Phone (918) 762-2517

042 Murray
Stillwater, OK 74078
Phone (405) 744-6021

5310 E 31st St
Ste 13
Tulsa, OK 74135
Phone (918) 561-5701

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

Dept 2563
Tulsa, OK 74182

Dept 1467
Tulsa, OK 74182

2345 Southwest Blvd
Tulsa, OK 74107
Phone (918) 582-1980

Interoperability endpoints

  • Direct secure messaging: dwildes734278@directa.mercy.net
  • Direct secure messaging: dwildes22915@muscogeecreeknation.direct-ci.com
  • Direct secure messaging: dwildes216565@direct.saintfrancis.com

Organizations & group practices 12

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1932163565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 E 31ST ST STE 13",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355013",
            "telephone_number": "918-561-5701",
            "fax_number": "918-561-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S HOUSTON AVE STE 400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279007",
            "telephone_number": "918-582-7711",
            "fax_number": "918-583-5831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Kenyon Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Dodge",
            "state": "IA",
            "postal_code": "505015776",
            "country_code": "US",
            "telephone_number": "515-574-6840",
            "fax_number": "515-576-7726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDES",
        "first_name": "DANIEL",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "4168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200031260B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "456078YM2Y",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.