1. Home
  2. Directory
  3. Virginia
  4. Portsmouth
  5. Pediatrics
  6. NPI Profile

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

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: August 02, 2026.

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

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
Open in Google Maps ↗

Other Names 1

Professional Name (2)Dr. Wade Wallace Wilde Md

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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
MRS. WILLAR MAE BAUM L.C.S.W.
Social Worker (Clinical)
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-9767

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.

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 4 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.