Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kevin William Wild, DPT

Individual provider Physical Therapist · NPI 1710431424

Dr. Kevin William Wild, DPT is a Physical Therapist in Private Practice in Novato, California. Qualified in 2016, 10 years ago. Practices with Grove Andersen Ghiringhelli Physical Therapy a Professional Co, a 10-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
10
Licensed in
CA
In the registry since
2016
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

88 Rowland Way Ste 250
Novato, CA 94945-5062
Phone: (415) 898-1311
Fax: (415) 897-0741
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT291755 (CA)

Record details

NPI number1710431424
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedAugust 10, 2016
Last updated in NPPESAugust 10, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Grove Andersen Ghiringhelli Physical Therapy A Professional Co — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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