DR. ROBERTA ANN WILDBLOOD (PSYD, MS, RN) – Clinical Child & Adolescent Psychologist, NPI 1902298250

DR. ROBERTA ANN WILDBLOOD (PSYD, MS, RN) is a healthcare provider. based in Orlando, Florida. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD, MS, RN. They hold a License No. PY8711 (FL). The NPI Number for DR. ROBERTA ANN WILDBLOOD (PSYD, MS, RN) is 1902298250

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
DR. ROBERTA ANN WILDBLOOD (PSYD, MS, RN)
NPI
1902298250
Phone
(407) 823-8421
Address
1400 N SEMORAN BLVD
Enumeration Date
24 February 2015
Last Update Date
24 February 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4078238421
Graduation Year
2001 (25 years ago)
PAC ID
0840517421
Group Practice PAC ID
1456518612
Professional Enrollment ID
I20150318002596
Address ID
FL328073536OR1400XBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:11State licenses:1Digital endpointsOther names

1,602 CLINICAL PSYCHOLOGIST in FL

Provider Addresses for DR. ROBERTA ANN WILDBLOOD (PSYD, MS, RN)

  • 1400 N SEMORAN BLVD

    SUITE E

    ORLANDO, FL 328073536

    Phone: (407) 823-8421

    Fax: (407) 823-8195

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-03-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150318002596IClinical PsychologistFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32807)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1456518612View full group profile
NameSpecialtyState
Clinical PsychologistPR
P S Y C H I A T R YFL
P S Y C H I A T R YMO

Reviews

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Frequently asked questions

Is DR. ROBERTA ANN WILDBLOOD (PSYD, MS, RN) listed with a National Provider Identifier?
Yes — DR. ROBERTA ANN WILDBLOOD (PSYD, MS, RN) has NPI 1902298250 on file in the registry.
Would DR. ROBERTA ANN WILDBLOOD (PSYD, MS, RN) appear as active to a payer?
You can treat DR. ROBERTA ANN WILDBLOOD (PSYD, MS, RN) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is DR. ROBERTA ANN WILDBLOOD (PSYD, MS, RN)?
DR. ROBERTA ANN WILDBLOOD (PSYD, MS, RN) is associated with Clinical Child & Adolescent Psychologist in the directory — Clinical services aligned with this taxonomy classification.
Is DR. ROBERTA ANN WILDBLOOD (PSYD, MS, RN) located near Orlando?
DR. ROBERTA ANN WILDBLOOD (PSYD, MS, RN) currently maps to Orlando, Florida in this extract.
Can I trust this NPI listing for DR. ROBERTA ANN WILDBLOOD (PSYD, MS, RN)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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