Dr Trevor Glade Wilde, DO is a medicare enrolled "Family Medicine" physician in Saint Anthony, Idaho. He went to At Still University, Arizona School Of Dentistry & Oral Hlth and graduated in 2012 and has 12 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Upper Valley Community Health Services Inc and his current practice location is
335 E Main St Ste 1, Saint Anthony, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 356-4900.
Dr Trevor Glade Wilde is licensed to practice in Idaho (license number O-0776) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1538422019.
Physician's Profile
| Full Name | Dr Trevor Glade Wilde |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 12 Years |
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| Location | 335 E Main St Ste 1, Saint Anthony, Idaho |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Trevor Glade Wilde attended and graduated from At Still University, Arizona School Of Dentistry & Oral Hlth in 2012
NPI Data:
- NPI Number: 1538422019
- Provider Enumeration Date: 06/20/2012
- Last Update Date: 08/16/2024
Medicare PECOS Information:
- PECOS PAC ID: 5597910836
- Enrollment ID: I20140731000138
Medical Identifiers
Medical identifiers for Dr Trevor Glade Wilde such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1538422019 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | O-0776 (Idaho) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Upper Valley Community Health Services Inc | 4385725282 | 17 |
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 Trevor Glade Wilde allows following entities to bill medicare on his behalf.
| Entity Name | Upper Valley Community Health Services Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1972792489
PECOS PAC ID: 4385725282
Enrollment ID: O20120611000120 |
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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 Trevor Glade 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 Address | Practice Location Address |
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Dr Trevor Glade Wilde, DO
Po Box 18,
Saint Anthony, ID 83445-0018
Ph: (208) 356-4900 | Dr Trevor Glade Wilde, DO
335 E Main St Ste 1,
Saint Anthony, ID 83445-1546
Ph: (208) 356-4900 |
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