AMANDA MARIE WILDERMAN
NPI 1659915171
Family Medicine - Adult Medicine in Carbondale, IL

Q: 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.

Q: What is Amanda Wilderman's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Wilderman was last updated on March 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since October 29, 2019PECOS Enrolled

100/100

CMS Quality Rating

1100 W DIANN LN, CARBONDALE, IL 62901(618) 549-8006(618) 549-8434 Get Directions Write a Review

NPPES record last updated: March 24, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 24, 2023, Oct 29, 2019 (2 updates tracked since 2019).

On this page

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 adult medicine provider in Carbondale, Illinois, licensed in Illinois (209.020318) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS, is affiliated with Herrin Hospital, and maintains a secondary practice location in Chester.

NPPES Registry Identity

NPI1659915171

Entity TypeIndividualFemale

Primary Taxonomy207QA0505X

Provider Legal NameAMANDA MARIE WILDERMAN

Location Address1100 W DIANN LNCarbondale, IL 62901-5339

Mailing Address1268 Cole Place RdChester, IL 62233-2054 · (618) 210-7478

Phone(618) 549-8006

Fax(618) 549-8434

Sole ProprietorYes

Medical School CMSOtherGraduated 2019

Enumeration DateOctober 29, 2019

Last NPPES UpdateMarch 24, 20232 updates tracked since enumeration

NPPES CertifiedMarch 24, 2023

✔ NPI 1659915171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QA0505X

License✔ Licensed in IL · 209.020318

Definition

The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

1100 W DIANN LN, Carbondale, IL 62901

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Secondary Practice Location 1

Location 11309 Allendale BlvdChester, IL 62233-1319 · Phone (618) 497-4264

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

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Herrin Hospital

Acute Care Hospitals · Herrin, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140011

Location201 S 14th StHerrin, IL 62948 · Williamson County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62901 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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

Quality

100

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 3

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

SOUTHERN ILLINOIS GI SPECIALISTS LLC

Internal Medicine (Gastroenterology)

1100 W DIANN LN
CARBONDALE, IL 62901

Jackson County (618) 549-8006

KAILE JEAN EGGEMEYER

Nurse Practitioner (Acute Care)

1100 W DIANN LN
CARBONDALE, IL 62901

Jackson County (618) 549-8006

ZAHOOR A MAKHDOOM MD

Internal Medicine (Gastroenterology)

1100 W DIANN LN
CARBONDALE, IL 62901

Jackson County (618) 549-8006

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 1100 W Diann Ln, Carbondale, IL 62901. The listed phone number is (618) 549-8006.

What is Amanda Wilderman's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Is Amanda Wilderman enrolled in Medicare?

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

Is Amanda Wilderman affiliated with any hospitals?

According to CMS data, Amanda Wilderman is affiliated with Herrin Hospital.

When was this NPI record last updated?

The NPPES record for Amanda Wilderman was last updated on March 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.