MARY K. WILDE MD
NPI 1508901810
Specialist in La Jolla, CA

NPI Status: Active since February 21, 2007

Contact Information

9850 GENESEE AVE STE 510
LA JOLLA, CA
ZIP 92037
Phone: (858) 623-2345
Fax: (858) 623-2343

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  • Individual
  • Female
  • Years of Experience 42
  • Specialist
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MARY WILDE

This page provides the complete NPI Profile along with additional information for Mary Wilde, a provider established in La Jolla, California with a medical specialization in Specialist and more than 42 years of experience. She graduated from University Of California, San Francisco School Of Medicine in 1984. The healthcare provider is registered in the NPI registry with number 1508901810 assigned on February 2007. The practitioner's primary taxonomy code is 174400000X with license number G65602 (CA). The provider is registered as an individual and her NPI record was last updated 18 years ago.

NPI
1508901810
Provider Name
MARY K. WILDE MD
Gender
Female
Entity Type
Individual
Location Address
9850 GENESEE AVE STE 510 LA JOLLA, CA 92037
Location Phone
(858) 623-2345
Location Fax
(858) 623-2343
Mailing Address
9850 GENESEE AVE STE 510 LA JOLLA, CA 92037
Mailing Phone
(858) 623-2345
Mailing Fax
(858) 623-2343
Medical School Name
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE
Graduation Year
1984
Is Sole Proprietor?
Yes
Enumeration Date
02-21-2007
Last Update Date
11-28-2007
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
G65602
License State
CA
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
WG65602CMEDICARE PIN (08)CA 

Medicare Participation & PECOS Enrollment Status

Mary Wilde is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Mary Wilde is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 446420533

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20110829000194

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Orthotic Devices

  • DME-Orthotic Devices (DF000N)

    Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type (HCPCS:L8000)

    3 DME suppliers used 18 Medicare Claims 50 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Biopsy or removal of deep lymph nodes of underarm

A biopsy or removal of deep underarm lymph nodes is a procedure where a small sample of lymph node tissue is taken for testing. This helps in diagnosing or ruling out conditions like infections or cancers. It involves a small incision and is typically done under local or general anesthesia.

This service was performed 38 times for 38 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 256 times for 168 patients

Imaging of lymph nodes during surgery

Imaging of lymph nodes during surgery involves taking detailed pictures of your lymph nodes to help surgeons see and assess them in real-time. This procedure can aid in detecting disease, guiding treatment, and improving surgical precision.

This service was performed 15 times for 15 patients

Mastectomy

A mastectomy is a surgical procedure that involves the removal of all or part of the breast tissue. This is often done to treat or prevent conditions related to abnormal cell growth. There are different types, ranging from removing only the breast tissue to also removing nearby structures. The approach depends on individual health circumstances.

This service was performed for 93 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 40 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 75 times for 75 patients

Partial removal of breast

A partial removal of the breast, also known as a lumpectomy, involves taking out a portion of the breast tissue to eliminate concerning cells. It's typically performed when the problem area is limited in size. This procedure helps to preserve most of the breast's appearance while aiming to remove all the unhealthy cells.

This service was performed 43 times for 40 patients

Placement of implant on same day of breast reconstruction

This procedure involves placing an implant during your breast reconstruction surgery. It's done on the same day to minimize the number of surgeries. It aims to restore the shape and size of your breast after a mastectomy, enhancing your physical appearance and comfort.

This service was performed 20 times for 20 patients

Repair of wound by transferring skin, 30.1-60.0 sq cm

This procedure involves repairing a wound by moving healthy skin from one area of the body to the wound site. The transferred skin, measuring between 30.1-60.0 square cm, aids in healing and reduces scarring.

This service was performed 27 times for 27 patients

Simple complete removal of breast

This procedure involves the total removal of breast tissue. It's typically done to treat or prevent conditions like cancer. The operation involves an incision on the skin, removal of the tissue, and closure of the wound. Post-surgery, care and recovery plans are provided.

This service was performed 15 times for 15 patients

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1508901810
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2508180282
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 0 + 8 + 1 + 8 + 0 + 2 + 8 + 2 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1508901810 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1790445229SYNERGY ORTHOPEDIC SPECIALISTS, INC.
Organization
Specialist9850 GENESEE AVE STE 510
LA JOLLA, CA 92037
(858) 450-9218
1831756105DR. COLBY BERGER DPM
Individual
Podiatrist (Foot & Ankle Surgery)9850 GENESEE AVE STE 510
LA JOLLA, CA 92037
(858) 450-9218
1023723913SOCAL FOOT CARE PC
Organization
Podiatrist (Foot & Ankle Surgery)9850 GENESEE AVE STE 510
LA JOLLA, CA 92037
(510) 399-0221

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1508901810, enumerated in the NPI registry as an "individual" on February 21, 2007

The provider is located at 9850 Genesee Ave Ste 510 La Jolla, Ca 92037 and the phone number is (858) 623-2345

The provider's speciality is Specialist with taxonomy code 174400000X

The provider has more than 42 years of experience. She graduated from University Of California, San Francisco School Of Medicine in 1984.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The most common procedures or services performed by this practitioner are: Biopsy or removal of deep lymph nodes of underarm, Established patient office or other outpatient visit, 40-54 minutes, Imaging of lymph nodes during surgery, Mastectomy, Melanoma (skin cancer) excision, New patient office or other outpatient visit, 60-74 minutes, Partial removal of breast, Placement of implant on same day of breast reconstruction, Repair of wound by transferring skin, 30.1-60.0 sq cm and Simple complete removal of breast.

This NPI record was last updated on February 21, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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