Dr Brandon J Wilde, CMHC - Medicare Counselor in Provo, UT

Dr Brandon J Wilde, CMHC is a medicare enrolled "Counselor - Mental Health" provider in Provo, Utah. His current practice location is 122 E 1700 S Bldg 3, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 900-3656.

Dr Brandon J Wilde is licensed to practice in Utah (license number 9471022-6044) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1710140447.

Contact Information

Dr Brandon J Wilde, CMHC
122 E 1700 S Bldg 3,
Provo, UT 84606-5644
(801) 900-3656
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameDr Brandon J Wilde
GenderMale
SpecialityCounselor - Mental Health
Location122 E 1700 S Bldg 3, Provo, Utah
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1710140447
  • Provider Enumeration Date: 07/02/2008
  • Last Update Date: 09/10/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 8527500842
  • Enrollment ID: I20240603000249

Medical Identifiers

Medical identifiers for Dr Brandon J Wilde such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1710140447NPI-NPPES
807197600MedicaidID
4290476MedicaidUT

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YM0800XCounselor - Mental Health 9471002-6004 (Utah)Secondary
101YM0800XCounselor - Mental Health LPC3887 (Idaho)Secondary
101YM0800XCounselor - Mental Health LPC-17502 (Arizona)Secondary
101YP2500XCounselor - Professional CP3313-R (Nevada)Secondary
101YM0800XCounselor - Mental Health 9471022-6044 (Utah)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Brandon J Wilde allows following entities to bill medicare on his behalf.
Entity NameRocky Mountain University Of Health Professions Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053174417
PECOS PAC ID: 7810439130
Enrollment ID: O20240603000185

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Brandon J Wilde is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Brandon J Wilde, CMHC
7897 N Broken Arrow Ln,
Eagle Mountain, UT 84005-7203

Ph: (602) 460-6428
Dr Brandon J Wilde, CMHC
122 E 1700 S Bldg 3,
Provo, UT 84606-5644

Ph: (801) 900-3656

Reviews and Comments


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Phone: 801-356-0014    Fax: 801-373-3655

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.