DR. WADE WALLACE WILDE MD
NPI 1225017817
Pediatrics in Portsmouth, VA

Q: What is Wade Wilde's NPI number?

The NPI number for Wade Wilde is 1225017817. It was assigned to this individual provider in the NPPES registry on January 11, 2006. The provider is also known as Dr. Wade Wallace Wilde MD.

Q: What is Wade Wilde's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Wade Wilde was last updated on March 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 January 11, 2006PECOS Enrolled

620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708(757) 953-7133(757) 953-7560 Get Directions Write a Review

NPPES record last updated: March 9, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 9, 2026, Nov 23, 2020 (2 updates tracked since 2020).

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About Dr. Wade Wallace Wilde Md NPPES

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

DR. WADE WALLACE WILDE MD (NPI 1225017817) is an individual pediatrics provider in Portsmouth, Virginia, licensed in Ohio (35.074229) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225017817

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameDR. WADE WALLACE WILDECredential: MD

Location Address620 JOHN PAUL JONES CIRPortsmouth, VA 23708-2111

Mailing Address620 John Paul Jones CirPortsmouth, VA 23708-2111

Phone(757) 953-7133

Fax(757) 953-7560

Sole ProprietorNo

Enumeration DateJanuary 11, 2006

Last NPPES UpdateMarch 9, 20262 updates tracked since enumeration

NPPES CertifiedMarch 9, 2026

✔ NPI 1225017817 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in OH · 35.074229✔ Licensed in VA · 0101232539

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

620 JOHN PAUL JONES CIR, Portsmouth, VA 23708

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Other Names 1

Professional Name (2)Dr. Wade Wallace Wilde Md

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Wade Wallace Wilde Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

Children's Hospital Medical Center Of Akron

372 mi

Anesthesiology

6505 MARKET ST
Boardman, OH 44512

Reassigned Medicare billing, Ohio enrollment
559 clinicians in this Medicare group

NPI 1417257601 (330) 746-8700

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 23708 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

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.

MEREDITH TVERDOSI CRNA

Nurse Anesthetist, Certified Registered

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-3238

ERIC FRANCIS SULAVA

Emergency Medicine

620 JOHN PAUL JONES CIR, NAVAL MEDICAL CENTER PORTSMOUTH
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-0669

MRS. TIFFNY KUPER RHH

Dental Hygienist

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-2711

DR. LAKEISHA GOODE PHARMD

Pharmacist

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-7462

JASMINE WOOD MD

Surgery

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-1895

NICHOLAS FANSELOW

General Practice

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-0669

DR. DAVID JESSEN MD

Military Health Care Provider

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-2518

DR. DANIEL VERNON UNGER M.D.

Orthopaedic Surgery

620 JOHN PAUL JONES CIR, NAVAL MEDICAL CENTER
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-1888

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 Wade Wilde's NPI number?

The NPI number for Wade Wilde is 1225017817. It was assigned to this individual provider in the NPPES registry on January 11, 2006. The provider is also known as Dr. Wade Wallace Wilde MD.

Where is Wade Wilde located?

Wade Wilde practices at 620 John Paul Jones Cir, Portsmouth, VA 23708. The listed phone number is (757) 953-7133.

What is Wade Wilde's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Wade Wilde enrolled in Medicare?

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

Which organization bills Medicare for Wade Wilde's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Wade Wilde reassigns Medicare benefits to Children's Hospital Medical Center Of Akron (Boardman, OH). 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 Wade Wilde'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 Wade Wilde was last updated on March 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.