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LEE ROSE WILDE
NPI 1700101060
Obstetrics & Gynecology in Flagstaff, AZ

Active since March 30, 2010PECOS EnrolledAccepts Medicare Assignment
70.58/100
CMS Quality Rating
2920 N 4TH ST, FLAGSTAFF, AZ 86004(928) 522-9400(928) 522-9736 Get Directions Write a Review

NPPES record last updated: May 12, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 12, 2026, Sep 1, 2023, Nov 22, 2019 (3 updates tracked since 2019).

About Lee Rose Wilde NPPES

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

LEE ROSE WILDE (NPI 1700101060) is an individual obstetrics & gynecology provider in Flagstaff, Arizona, licensed in Arizona (00821) and active in the NPI registry since March 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1700101060
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameLEE ROSE WILDE
Location Address2920 N 4TH STFlagstaff, AZ 86004-1816
Mailing AddressPo Box 1231Tucson, AZ 85702-1231 · (520) 670-3909 · Fax (520) 309-2560
Phone(928) 522-9400
Fax(928) 522-9736
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateMarch 30, 2010
Last NPPES UpdateMay 12, 20263 updates tracked since enumeration
NPPES CertifiedMay 12, 2026
✔ NPI 1700101060 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in AZ · 00821
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
2920 N 4TH ST, Flagstaff, AZ 86004
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross Blue Shield of Arizona and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lee Rose Wilde is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052554847
PECOS Enrollment IDI20240930002474
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

4

Medicare enrollment records show Lee Wilde reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Tuba City Regional Health Care Corporation
2.8 mi
Family Medicine
6300 N HIGHWAY 89
Flagstaff, AZ 86004
  • Reassigned Medicare billing, Texas enrollment
  • 540 clinicians in this Medicare group
NPI 1376773341 (928) 863-7333
Summit Healthcare Medical Associates
84 mi
Rural Health
2352 QUARTER HORSE TRAIL
Overgaard, AZ 85933
  • Reassigned Medicare billing, Arizona enrollment
  • 99 clinicians in this Medicare group
NPI 1770700767 (928) 535-3616
El Rio Santa Cruz Neighborhood Health Center, Inc
208 mi
Federally Qualified Health Center (FQHC)
3655 E GRANT RD
Tucson, AZ 85716
  • Reassigned Medicare billing, Arizona enrollment
  • 464 clinicians in this Medicare group
NPI 1477204485 (520) 670-3090
Northwest Medical Foundation Of Tillamook
886 mi
Rural Health
24461 E WELCHES RD
Welches, OR 97067
  • Reassigned Medicare billing, Oregon enrollment
  • Also billed through NPI 1699146159 (Oregon)
  • 206 clinicians in this Medicare group
NPI 1861944894 (503) 842-4444

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

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 low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
17 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86004 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
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
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.

70.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality39.68
Promoting Interoperability79
Improvement Activities40
Cost63.1

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.

DUNYA COPE LPC
Counselor (Professional)
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 522-9400
CHLOE STRIKE RDH
Dental Hygienist
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 522-9400
KARIS HINAE JO YUN CHOY
Pharmacist
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 522-9400
DR. JORDAN MICHAEL HAHN PHARMD
Pharmacist
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 522-9400
DR. JOHN PAUL GRAZIANO M.D.
Obstetrics & Gynecology
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 522-9400
KATRINA MIKITIK RN
Registered Nurse
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 864-9374
EMILY H NIETO DMD, MPH
Dentist
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 522-9405
KATRINA BURLEIGH WILSON DO
Obstetrics & Gynecology
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 522-9400

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 Lee Wilde's NPI number?

The NPI number for Lee Wilde is 1700101060. It was assigned to this individual provider in the NPPES registry on March 30, 2010.

Where is Lee Wilde located?

Lee Wilde practices at 2920 N 4th St, Flagstaff, AZ 86004. The listed phone number is (928) 522-9400.

What is Lee Wilde's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Lee Wilde enrolled in Medicare?

Yes. Lee Wilde is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Lee Wilde's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lee Wilde reassigns Medicare benefits to 4 organizations: Tuba City Regional Health Care Corporation (Flagstaff, AZ), Summit Healthcare Medical Associates (Overgaard, AZ), El Rio Santa Cruz Neighborhood Health Center, Inc (Tucson, AZ) and Northwest Medical Foundation Of Tillamook (Welches, OR). 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 Lee Wilde's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lee Wilde accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, BridgeSpan Health Company and Imperial Insurance Companies, Inc. and 3 other insurers list Lee Wilde as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lee Wilde was last updated on May 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.