Chad A Hilmo, OTD, OTR/L
Individual provider Active NPI Pediatrics Physician · Boise, ID
NPI 1073981981 · NPPES record last updated Mar 9, 2022
Key facts
- NPI
- 1073981981
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- OT-2257 (ID)
- Practice address
- 4713 S Silvermaple Ave
Boise, ID 83709-5781 - Phone
- (213) 800-3096
- NPI assigned
- Sep 9, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
245 N 3Rd
Mountain Home, ID 83647-2734
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210326001907 | ID | Practitioner - Occupational Therapist in Private Practice | 0941617559 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT-2257 | ID | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skybreak Therapy, PLLC | Pediatrics | Current |
Accepting new patients |
| Special Service for Groups, Inc. | Past | Accepting new patients |
Locations
10112 W Overland Rd
Boise, ID 83709
Phone (208) 495-5401
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Occupational Therapist | 225XM0800X | |||
| Pediatrics Physician | 208000000X | OT-2257 | ID | Yes |
Addresses
Primary practice location
4713 S Silvermaple Ave
Boise, ID 83709-5781
Mailing address
4713 S Silvermaple Ave
Boise, ID 83709-5781
Phone (213) 800-3096
Other practice location 1
19401 S Vermont Ave Ste A200
Torrance, CA 90502-4418
Phone (310) 323-6887
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.