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DEANNA WILDE MSW, LICSW
NPI 1053188425
Social Worker in Willmar, MN

Active since December 06, 2023PECOS Enrolled
1708 1ST ST S, WILLMAR, MN 56201(218) 999-7750 Get Directions Write a Review

NPPES record last updated: July 14, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 14, 2026, Dec 6, 2023 (2 updates tracked since 2023).

About Deanna Wilde Msw, Licsw NPPES

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

DEANNA WILDE MSW, LICSW (NPI 1053188425) is an individual social worker in Willmar, Minnesota, licensed in Minnesota (31957) and active in the NPI registry since December 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1053188425
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameDEANNA WILDECredential: MSW, LICSW
Location Address1708 1ST ST SWillmar, MN 56201-4228
Mailing Address1708 1st St SWillmar, MN 56201-4228 · (218) 999-7750
Phone(218) 999-7750
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateDecember 6, 2023
Last NPPES UpdateJuly 14, 20262 updates tracked since enumeration
NPPES CertifiedJuly 14, 2026
✔ NPI 1053188425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in MN · 31957
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
1708 1ST ST S, Willmar, MN 56201
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Other Identifiers 1

Medicaid1003042656MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Deanna Wilde Msw, Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5193283646
PECOS Enrollment IDI20260815000084
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 Deanna Wilde reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Modern Mojo
164 mi
Mental Health (Including Community Mental Health Center)
28 NW 4TH ST, SUITE A
Grand Rapids, MN 55744
  • Reassigned Medicare billing, Minnesota enrollment
  • 7 clinicians in this Medicare group
NPI 1902344591 (218) 999-7750

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

Other Providers at the Same Location NPPES 2

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

STEFFANIE SUE SMITH PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1708 1ST ST S
WILLMAR, MN 56201
Kandiyohi County (218) 999-7750
LISA RENEE THIELKE APRN, CNP, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1708 1ST ST S
WILLMAR, MN 56201
Kandiyohi County (218) 999-7750

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 Deanna Wilde's NPI number?

The NPI number for Deanna Wilde is 1053188425. It was assigned to this individual provider in the NPPES registry on December 6, 2023.

Where is Deanna Wilde located?

Deanna Wilde practices at 1708 1st St S, Willmar, MN 56201. The listed phone number is (218) 999-7750.

What is Deanna Wilde's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Deanna Wilde enrolled in Medicare?

Yes. Deanna Wilde is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Deanna Wilde's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Deanna Wilde reassigns Medicare benefits to Modern Mojo (Grand Rapids, MN). 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 Deanna Wilde's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Deanna Wilde accept?

Health plans from HealthPartners list Deanna Wilde as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Deanna Wilde was last updated on July 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.