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DR. BERNADETTE MARIA MANDES WILDEMORE MD
NPI 1487863858
Pathology - Anatomic Pathology & Clinical Pathology in Dahlonega, GA

Active since May 22, 2007PECOS Enrolled
134 ANSLEY DR STE 500, DAHLONEGA, GA 30533(678) 853-2419 Get Directions Write a Review

NPPES record last updated: June 20, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Bernadette Maria Mandes Wildemore Md NPPES

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

DR. BERNADETTE MARIA MANDES WILDEMORE MD (NPI 1487863858) is an individual anatomic pathology & clinical pathology provider in Dahlonega, Georgia, licensed in Pennsylvania (MD430740) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS and is a graduate of Jefferson Medical College Of Thomas Jefferson University (2003).

NPPES Registry Identity

NPI1487863858
Entity TypeIndividualFemale
Primary Taxonomy207ZP0102X
Provider Legal NameDR. BERNADETTE MARIA MANDES WILDEMORECredential: MD
Location Address134 ANSLEY DR STE 500Dahlonega, GA 30533-1641
Mailing Address4405 Roseman TrlCumming, GA 30040-9367 · (215) 609-7472
Phone(678) 853-2419
Sole ProprietorNo
Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 2003
Enumeration DateMay 22, 2007
Last NPPES UpdateJune 20, 2014
✔ NPI 1487863858 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
License✔ Licensed in PA · MD430740
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
Also ListedSpecialistTaxonomy 174400000X · License 2013-02274 (NC), 70607 (GA), MD.33137 (AL), MD430740 (PA), MD36443 (SC), 242668 (MA), MD50706 (TN)
134 ANSLEY DR STE 500, Dahlonega, GA 30533
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Bernadette Maria Mandes Wildemore Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4183934961
PECOS Enrollment IDI20260407003506
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 Reassignments

2

Medicare enrollment records show Bernadette Wildemore reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mira Precision Health, Inc
332 mi
Clinical Medical Laboratory
5155 FINANCIAL WAY STE 15
Mason, OH 45040
  • Reassigned Medicare billing, Ohio enrollment
NPI 1033724109 (513) 972-4621
American Physician Group Inc
557 mi
Multi-Specialty
9150 CRAWFORD AVE STE 205
Skokie, IL 60076
  • Reassigned Medicare billing, Illinois enrollment
NPI 1033955927 (847) 585-3340

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 30533 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

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 Bernadette Wildemore's NPI number?

The NPI number for Bernadette Wildemore is 1487863858. It was assigned to this individual provider in the NPPES registry on May 22, 2007.

Where is Bernadette Wildemore located?

Bernadette Wildemore practices at 134 Ansley Dr Ste 500, Dahlonega, GA 30533. The listed phone number is (678) 853-2419.

What is Bernadette Wildemore's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Bernadette Wildemore enrolled in Medicare?

Yes. Bernadette Wildemore is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Bernadette Wildemore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bernadette Wildemore reassigns Medicare benefits to 2 organizations: Mira Precision Health, Inc (Mason, OH) and American Physician Group Inc (Skokie, IL). Each 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 Bernadette Wildemore'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 Bernadette Wildemore was last updated on June 20, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.