Crystal Wildes, PSYD, LP in Evergreen, CO - Medicare Psychologist Provider

Crystal Wildes, PSYD, LP is a medicare enrolled "Psychologist - Clinical" provider in Evergreen, Colorado. Her current practice location is 4611 Plettner Ln, Ste. 100, Evergreen, Colorado. You can reach out to her office (for appointments etc.) via phone at (720) 443-3112.

Crystal Wildes is licensed to practice in Colorado (license number PSY.0004027) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1003121898.

Contact Information

	Crystal Wildes, PSYD, LP
	4611 Plettner Ln, Ste. 100, Evergreen, CO 80439-7396
	(720) 443-3112
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Crystal Wildes
Gender	Female
Speciality	Psychologist - Clinical
Location	4611 Plettner Ln, Evergreen, Colorado
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003121898
Provider Enumeration Date: 08/17/2010
Last Update Date: 02/24/2025

Medicare PECOS Information:

PECOS PAC ID: 9436449147
Enrollment ID: I20160609000170

Medical Identifiers

Medical identifiers for Crystal Wildes such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003121898	NPI	-	NPPES
9000154871	Medicaid	CO

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	PSY.0004027 (Colorado)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Crystal Wildes allows following entities to bill medicare on her behalf.

Entity Name	Community Reach Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316906886 PECOS PAC ID: 4284526971 Enrollment ID: O20040326001266

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Crystal Wildes is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Crystal Wildes, PSYD, LP 4611 Plettner Ln Ste 100, Evergreen, CO 80439-7396 Ph: (720) 443-3112	Crystal Wildes, PSYD, LP 4611 Plettner Ln, Ste. 100, Evergreen, CO 80439-7396 Ph: (720) 443-3112

Reviews and Comments

Psychologist in Evergreen, CO

Dr. Terry Michael Levy, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 32065 Castle Ct, Ste 325 Evergreen Psychotherapy Ctr, Evergreen, CO 80439 Phone: 303-674-4029 Fax: 303-674-4078
Dr. Jonathan Keith Brooks, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 29029 Upper Bear Creek Rd Ste 305, Evergreen, CO 80439 Phone: 303-838-7595
Dr. Elizabeth A Gray, PH.D PSYCHOLOGY Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3092 Evergreen Parkway, Suite 200, Evergreen, CO 80439 Phone: 720-244-0019
Dr. Karrie Ann Lyons-sjostrom, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 29029 Upper Bear Creek Rd Ste 301, Evergreen, CO 80439 Phone: 720-254-4093
Laurel Nook, MA, LPCC Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3560 Evergreen Pkwy Ste 103, Evergreen, CO 80439 Phone: 720-233-0353
Sarah Eleanor Gillingham, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4550 Sw Summit Trl, Evergreen, CO 80439 Phone: 303-674-2566

Crystal Wildes, PSYD, LP - Medicare Psychologist in Evergreen, CO