NPIMap

Individual provider Active NPI

Cynthia Kay Wilder, M.D.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1942213392
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L9553 Issued in TX
Practice address
3900 Junius St Ste 415
Dallas, TX 75246-1617
Phone
(972) 993-8300
Fax
(972) 993-8301
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L9553 TX Primary

Addresses

Primary practice location

3900 Junius St Ste 415
Dallas, TX 75246-1617

Mailing address

3417 Gaston Ave Ste 700
Dallas, TX 75246-2031
Phone (972) 993-5000

Other identifiers 2

IdentifierTypeStateIssuer
165931002MedicaidTX
8A0787OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040804000301 TX Practitioner - Internal Medicine 5698746550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Abksw Preferred Health Partners, PLLCGroup PAC ID 2961710892, 48 clinicians

Practice addresses (Care Compare)

3900 Junius St
Suite 415
Dallas, TX 75246-1617
Phone (972) 993-8300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Abksw Preferred Health Partners, PLLC Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Healthtexas Provider Network Internal Medicine CurrentSince Oct 15, 2018 Accepting new patients
Healthtexas Provider Network CurrentSince Oct 15, 2018 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3417 Gaston Ave
Ste 700
Dallas, TX 75246
Phone (214) 823-4800

3900 Junius St
Ste 415
Dallas, TX 75246
Phone (214) 820-7100

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

440 W Lyndon B Johnson Fwy
Ste 405
Irving, TX 75063
Phone (214) 823-4800

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1942213392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 GASTON AVE STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462031",
            "telephone_number": "972-993-5000",
            "fax_number": "972-993-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 JUNIUS ST STE 415",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461617",
            "telephone_number": "972-993-8300",
            "fax_number": "972-993-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "CYNTHIA",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L9553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165931002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8A0787",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.