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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

AMANDA MARIE WILDERMAN
NPI 1659915171
Nurse Practitioner - Gerontology in Coulterville, IL

Active since October 29, 2019PECOS Enrolled
100/100
CMS Quality Rating
13138 ILLINOIS 13, COULTERVILLE, IL 62237(618) 758-2256 Get Directions Write a Review

NPPES record last updated: August 25, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 25, 2026, Mar 24, 2023, Oct 29, 2019 (3 updates tracked since 2019).

About Amanda Marie Wilderman NPPES

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

AMANDA MARIE WILDERMAN (NPI 1659915171) is an individual gerontology provider in Coulterville, Illinois, licensed in Illinois (209.020318) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1659915171
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameAMANDA MARIE WILDERMAN
Location Address13138 ILLINOIS 13Coulterville, IL 62237
Mailing Address1268 Cole Place RdChester, IL 62233-2054 · (618) 210-7478
Phone(618) 758-2256
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateOctober 29, 2019
Last NPPES UpdateAugust 25, 20263 updates tracked since enumeration
NPPES CertifiedAugust 25, 2026
✔ NPI 1659915171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in IL · 209.020318
13138 ILLINOIS 13, Coulterville, IL 62237
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Marie Wilderman is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2668896390
PECOS Enrollment IDI20200728000888
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
525 services290 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
102 services102 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62237 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
$88.44 typical visit price
range $56.28 – $173.35
Typical copayment $22.11 (range $14.07 – $43.33)
Most-billed visit code 99203
Established Patient
$99.71 typical visit price
range $17.51 – $139.99
Typical copayment $24.92 (range $4.37 – $34.99)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES

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

MEGAN BLEEM
Physical Therapy Assistant
13138 ILLINOIS 13
COULTERVILLE, IL 62237
Randolph County (618) 758-2256

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 Amanda Wilderman's NPI number?

The NPI number for Amanda Wilderman is 1659915171. It was assigned to this individual provider in the NPPES registry on October 29, 2019.

Where is Amanda Wilderman located?

Amanda Wilderman practices at 13138 Illinois 13, Coulterville, IL 62237. The listed phone number is (618) 758-2256.

What is Amanda Wilderman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Amanda Wilderman enrolled in Medicare?

Yes. Amanda Wilderman is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Amanda Wilderman was last updated on August 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days 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.