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MR. JOHN DAVID WILDGUST RN, MSN, PHN, PMHNP
NPI 1013698232
Nurse Practitioner - Psychiatric/Mental Health in Santa Rosa, CA

Active since July 31, 2023PECOS EnrolledAccepts Medicare Assignment
480 TESCONI CIR STE B, SANTA ROSA, CA 95401(707) 206-7268(707) 206-7254 Get Directions Write a Review

NPPES record last updated: April 9, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mr. John David Wildgust Rn, Msn, Phn, Pmhnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JOHN DAVID WILDGUST RN, MSN, PHN, PMHNP (NPI 1013698232) is an individual psychiatric/mental health provider in Santa Rosa, California, licensed in California (NP95034156) and active in the NPI registry since July 2023. He is enrolled in Medicare PECOS, maintains a secondary practice location in Santa Rosa, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1013698232
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameMR. JOHN DAVID WILDGUSTCredential: RN, MSN, PHN, PMHNP
Location Address480 TESCONI CIR STE BSanta Rosa, CA 95401-4691
Mailing Address935 Hunter LnSanta Rosa, CA 95404-8717 · (707) 480-2030 · Fax (707) 588-9032
Phone(707) 206-7268
Fax(707) 206-7254
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJuly 31, 2023
Last NPPES UpdateApril 9, 2025
NPPES CertifiedApril 9, 2025
✔ NPI 1013698232 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · NP95034156
Also ListedRegistered Nurse · Medical-SurgicalTaxonomy 163WM0705X · License 78261 (CA)
480 TESCONI CIR STE B, Santa Rosa, CA 95401
Open in Google Maps ↗

Secondary Practice Location 1

Location 1935 Hunter LnSanta Rosa, CA 95404-8717 · Phone (707) 480-2030 · Fax (707) 588-9032

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. John David Wildgust Rn, Msn, Phn, Pmhnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062921026
PECOS Enrollment IDI20250602000979
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show John Wildgust reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Siyan Clinical Corporation
Same address
Psychiatry
480 TESCONI CIR STE B
Santa Rosa, CA 95401
  • Reassigned Medicare billing, California enrollment
  • 37 clinicians in this Medicare group
NPI 1568732972 (707) 206-7268

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.16 typical visit price
range $63.04 – $187.01
Typical copayment $24.04 (range $15.76 – $46.75)
Most-billed visit code 99203
Established Patient
$109.88 typical visit price
range $21.02 – $153.40
Typical copayment $27.47 (range $5.25 – $38.35)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACQUELINE MCCARRICK
Marriage & Family Therapist
480 TESCONI CIR STE B
SANTA ROSA, CA 95401
Sonoma County (707) 206-7268
MS. AMBER RAMIREZ
Case Manager/Care Coordinator
480 TESCONI CIR STE B
SANTA ROSA, CA 95401
Sonoma County (707) 206-7268
MS. ANDRIE IRONS
Marriage & Family Therapist
480 TESCONI CIR STE B
SANTA ROSA, CA 95401
Sonoma County (707) 206-7268
SIYAN CLINICAL RESEARCH
Substance Abuse Rehabilitation Facility
480 TESCONI CIR STE B
SANTA ROSA, CA 95401
Sonoma County (707) 206-7268
DR. ANISH SUNDERRAJAN SHAH M.D
Psychiatry & Neurology (Psychiatry)
480 TESCONI CIR STE B
SANTA ROSA, CA 95401
Sonoma County (707) 206-7268
STEPHEN CLAY WILLIAMS M.D.
Psychiatry & Neurology (Psychiatry)
480 TESCONI CIR STE B
SANTA ROSA, CA 95401
Sonoma County (707) 206-7268
JESSICA SICKLER SCHMIDT PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
480 TESCONI CIR STE B
SANTA ROSA, CA 95401
Sonoma County (707) 206-7268
THERESA CARLA NEGRIDO JOHNSON PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
480 TESCONI CIR STE B
SANTA ROSA, CA 95401
Sonoma County (707) 206-7268

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Wildgust's NPI number?

The NPI number for John Wildgust is 1013698232. It was assigned to this individual provider in the NPPES registry on July 31, 2023.

Where is John Wildgust located?

John Wildgust practices at 480 Tesconi Cir Ste B, Santa Rosa, CA 95401. The listed phone number is (707) 206-7268.

What is John Wildgust's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is John Wildgust enrolled in Medicare?

Yes. John Wildgust is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for John Wildgust's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Wildgust reassigns Medicare benefits to Siyan Clinical Corporation (Santa Rosa, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for John Wildgust's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for John Wildgust was last updated on April 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.