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DR. BRANDON D WILDE D.P.M. NPI 1407169865


NPI Information

NPI: 1407169865
Provider Name: DR. BRANDON D WILDE, D.P.M.
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

PECOS Registration: Yes

Address:
1455 BENCH RD STE B
POCATELLO, ID
ZIP 83201
Phone: (208) 232-0006
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DR. Brandon D Wilde, D.P.M. is a foot and ankle surgery podiatrist in Pocatello, ID. DR. Brandon D Wilde, D.P.M. NPI is 1407169865. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1455 BENCH RD STE B
POCATELLO, ID
ZIP 83201-084
Phone: (208) 232-0006
Fax: (208) 233-8771

The NPI 1407169865 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • X-ray of foot, minimum of 3 views (HCPCS:73630)
  • Removal of tissue from 6 or more finger or toe nails (HCPCS:11721)
  • Removal of skin and tissue first 20 sq cm or less (HCPCS:11042)
  • Removal of tissue from 1 to 5 finger or toe nails (HCPCS:11720)

The enumeration date for this NPI number is 7/14/2010 and was last updated on 11/14/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213ES0103XPodiatristFoot & Ankle SurgeryP-217IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1P01271994OTHERMISSOURIRAILROAD MEDICARE
21407169865MEDICAIDMISSOURI
3149630009MEDICARE PINMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.