JOHN A WILDER (PH.D.) – Psychologist, NPI 1164517819

JOHN A WILDER (PH.D.) is a healthcare provider. based in Clearwater, Florida. specializing in Psychologist. They hold the professional credentials PH.D.. They hold a License No. P3005 (NC). The NPI Number for JOHN A WILDER (PH.D.) is 1164517819

Main info

Male
Name
JOHN A WILDER (PH.D.)
NPI
1164517819
Phone
(800) 632-6074
Address
13575 58TH ST N
Enumeration Date
4 October 2006
Last Update Date
27 February 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness75
Years active:19State licenses:2Digital endpointsOther names

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Provider Addresses for JOHN A WILDER (PH.D.)

  • Passport Health Clearwater Travel Clinic, 13575, 58th Street North, Clearwater, Pinellas County, Florida, 33760, United States

    SUITE 187

    CLEARWATER, FL 337603740

    Phone: (800) 632-6074

    Type: Mailing

  • 14818, Capricorn Lane, Allyson Park, Charlotte, Mecklenburg County, North Carolina, 28277, United States

    CHARLOTTE, NC 282772927

    Phone: (704) 517-2138

    Type: Location

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: 2005-10-06

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
I20051006000939IClinical PsychologistNCTBD

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

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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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90832Psychotherapy, 30 minutes26311$0
View full utilization report →

Insurance plans in this area (ZIP 33760)

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Reviews

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Frequently asked questions

Can I verify JOHN A WILDER (PH.D.) with an NPI only?
You can start verification with NPI 1164517819 for JOHN A WILDER (PH.D.), then check state licensing separately.
Does the file indicate JOHN A WILDER (PH.D.) is practicing under active NPI?
Directory data currently reports JOHN A WILDER (PH.D.) as active.
What is JOHN A WILDER (PH.D.) best known for clinically?
Directory data describes JOHN A WILDER (PH.D.) with Psychologist. Clinical services aligned with this taxonomy classification.
What address line appears for JOHN A WILDER (PH.D.)?
JOHN A WILDER (PH.D.)'s geographic hint is Clearwater, Florida in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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