CAROL JEAN WILDER (MD) – Family Medicine Physician, NPI 1801982749
Family Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
88 SPORTS MEDICINE in OR
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Provider Addresses for CAROL JEAN WILDER (MD)
3158, Southwest 87th Avenue, Portland, Metro, Washington County, Oregon, 97225, United States
PORTLAND, OR 972083158
Phone: (541) 732-3650
Type: Mailing
Providence Stewart Meadows Urgent Care, 70, Bower Drive, Medford, Jackson County, Oregon, 97501, United States
MEDFORD, OR 97501
Phone: (541) 734-3650
Fax: (206) 368-6101
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $76.
Total Amount is formed as General ($76) + Research ($0) + Ownership ($0) = $76.
Last reported payment date: 2023-06-21 • Largest payer in this snapshot: SI-BONE, INC. ($76).
Total Amount
$76
General + Research + Ownership
Payments
1
Total payment records
General Amount
$76
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| SI-BONE, INC. | $76 |
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: 2017-12-14
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171214000434 | I | Sports Medicine | OR | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J7325 | Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg | 802 | 12 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 202 | 118 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 196 | 39 | $0 |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 70 | 39 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 31 | 31 | $0 |
Insurance plans in this area (ZIP 97208)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CA | |
| Nurse Practitioner | PA | |
| - | OR | |
| Physician Assistant | OR | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | OR | |
| Physician Assistant | MT | |
| - | OR | |
| Nurse Practitioner | OR | |
| Physician Assistant | OR |
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