Individual provider Active NPI

Marcus Benjamin Hiller, PA-C

  • Physician Assistant
  • Salisbury, NC
National Provider Identifier
1073088290
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08518 Issued in NC
Practice address
605 Grove St
Salisbury, NC 28144-3233
Phone
(704) 633-6442
Fax
(704) 633-7569
NPI assigned
Oct 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-08518 NC Primary

Addresses

Primary practice location

605 Grove St
Salisbury, NC 28144-3233

Mailing address

Medical Center Blvd.
Winston Salem, NC 27157-0001
Phone (336) 716-1332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190115001716 NC Practitioner - Physician Assistant 7911243738 Reassigns benefits to 1 organization
I20241007001064 SC Practitioner - Physician Assistant 7911243738

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

250 Hospital Dr
Lexington, NC 27292-6792
Phone (336) 716-2734

2718 Henry St
Greensboro, NC 27405-3633
Phone (336) 375-1007

320 Jake Alexander Blvd W
Salisbury, NC 28147-1442
Phone (704) 636-0052

4515 Premier Dr
High Point, NC 27265-8356

510 Emergency Dr
Lexington, NC 27292-6804
Phone (336) 716-2255

605 Grove St
Salisbury, NC 28144-3233
Phone (704) 633-6442

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5433SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Nov 14, 2018 Accepting new patients

Locations

605 Grove St
Salisbury, NC 28144
Phone (704) 633-6442

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: marcus.hiller@hca5.eclinicaldirectplus.com
  • Direct secure messaging: mhiller2755643@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1073088290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD.",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 GROVE ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281443233",
            "telephone_number": "704-633-6442",
            "fax_number": "704-633-7569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLER",
        "first_name": "MARCUS",
        "middle_name": "BENJAMIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-04",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.