DR. ROBERT S. WILDIN (MD) – Clinical Genetics (M.D.) Physician, NPI 1073586897
Clinical Genetics (M.D.) Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. ROBERT S. WILDIN (MD)
111 COLCHESTER AVE
BURLINGTON, VT 054011473
Phone: (802) 847-0000
Type: Location
St. Luke's Boise Medical Center, 190, East Bannock Street, Downtown, Boise, Ada County, Idaho, 83712, United States
ST. LUKE'S CHILDREN'S SPECIALTY CTR (CSC SUITE 200)
BOISE, ID 837126241
Phone: (208) 381-7339
Fax: (208) 381-6186
Type: Location
6140, Southwest 41st Avenue, Hayhurst, Portland, Multnomah County, Oregon, 97221, United States
PORTLAND, OR 972213344
Phone: (503) 768-9547
Fax: (503) 768-9547
Type: Mailing
PO BOX 1063
BURLINGTON, VT 054021063
Phone: (802) 847-0000
Type: Mailing
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: 2019-02-07
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 |
|---|---|---|---|---|
| I20190207001827 | I | Medical Genetics And Genomics | VT | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 05401)
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