Individual provider Active NPI

Chad A Hilmo, OTD, OTR/L

  • Pediatrics Physician
  • Boise, ID
National Provider Identifier
1073981981
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OT-2257 Issued in ID
Practice address
4713 S Silvermaple Ave
Boise, ID 83709-5781
Phone
(213) 800-3096
NPI assigned
Sep 9, 2015
Last updated
Mar 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
OT-2257IDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skybreak Therapy, PLLC Pediatrics CurrentSince Feb 24, 2022 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.

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.

Verify at the official NPI Registry.