HERSCHEL W. WILDE MD
NPI 1073194114
Psychiatry & Neurology - Psychiatry in Ogden, UT

Q: What is Herschel Wilde's NPI number?

The NPI number for Herschel Wilde is 1073194114. It was assigned to this individual provider in the NPPES registry on April 20, 2021.

Q: What is Herschel Wilde's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Herschel Wilde was last updated on May 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.

Active since April 20, 2021PECOS EnrolledAccepts Medicare Assignment

4401 HARRISON BLVD, OGDEN, UT 84403(801) 387-5502 Get Directions Write a Review

NPPES record last updated: May 20, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 20, 2025, Aug 16, 2022, Apr 20, 2021 (3 updates tracked since 2021).

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About Herschel W. Wilde Md NPPES

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

HERSCHEL W. WILDE MD (NPI 1073194114) is an individual psychiatry provider in Ogden, Utah, licensed in Utah (12985877-1205) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in Salt Lake City, and is a graduate of University Of Utah School Of Medicine (2021).

NPPES Registry Identity

NPI1073194114

Entity TypeIndividualMale

Primary Taxonomy2084P0800X

Provider Legal NameHERSCHEL W. WILDECredential: MD

Location Address4401 HARRISON BLVDOgden, UT 84403-3195

Mailing AddressPo Box 27128Salt Lake City, UT 84127-0128 · (801) 387-5502

Phone(801) 387-5502

Sole ProprietorNo

Medical School CMSUniversity Of Utah School Of MedicineGraduated 2021

Enumeration DateApril 20, 2021

Last NPPES UpdateMay 20, 20253 updates tracked since enumeration

NPPES CertifiedMay 20, 2025

✔ NPI 1073194114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

License✔ Licensed in UT · 12985877-1205

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

4401 HARRISON BLVD, Ogden, UT 84403

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Secondary Practice Location 1

Location 1501 S Chipeta WaySalt Lake City, UT 84108-1222 · Phone (801) 585-0895

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

Herschel W. Wilde Md 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 ID3870977358

PECOS Enrollment IDI20250602002703

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 Herschel Wilde reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ihc Health Services Inc

Same address

Critical Care Medicine

4401 HARRISON BLVD
Ogden, UT 84403

Reassigned Medicare billing, Utah enrollment
Also billed through NPI 1033240965 (Utah)
3,691 clinicians in this Medicare group

NPI 1366764813 (801) 357-2035

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 84403 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

$166.03 typical visit price

range $54.34 – $166.03

Typical copayment $41.50 (range $13.58 – $41.50)

Most-billed visit code 99205

Established Patient

$68.01 typical visit price

range $17.23 – $135.20

Typical copayment $17.00 (range $4.30 – $33.80)

Most-billed visit code 99213

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.

MIKHAIL SHIPOTKO MD

Hospitalist