Active NPI
Chad A Hilmo, OTD, OTR/L
- Pediatrics Physician
- Boise, ID
National Provider Identifier
1073981981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- OT-2257
- Practice address
- 4713 S Silvermaple Ave
Boise, ID 83709-5781 - Phone
- (213) 800-3096
- NPI assigned
- Sep 9, 2015
- Last updated
- Mar 9, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Occupational Therapist | 225XM0800X | |||
| Pediatrics Physician | 208000000X | OT-2257 | ID | Primary |
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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210326001907 | ID | Practitioner - Occupational Therapist in Private Practice | 0941617559 |
Care Compare profile
Medicare Care Compare- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Adolescent and Children Mental Health Clinic/Center
- Los Angeles, CA
- NPI 1982735932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646784000000",
"number": "1073981981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4713 S SILVERMAPLE AVE",
"city": "BOISE",
"state": "ID",
"postal_code": "837095781",
"telephone_number": "213-800-3096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4713 S SILVERMAPLE AVE",
"city": "BOISE",
"state": "ID",
"postal_code": "837095781",
"telephone_number": "213-800-3096"
}
],
"practiceLocations": [
{
"address_1": "19401 S Vermont Ave Ste A200",
"address_purpose": "LOCATION",
"city": "Torrance",
"state": "CA",
"postal_code": "905024418",
"country_code": "US",
"telephone_number": "310-323-6887",
"fax_number": "310-436-8285",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HILMO",
"first_name": "CHAD",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-09",
"last_updated": "2022-03-09",
"certification_date": "2022-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "225XM0800X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "ID",
"license": "OT-2257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.