NPIMap

Organization Active NPI

Elise Chang Hillmann MD PA

  • Dermatopathology Physician
  • Jupiter, FL
National Provider Identifier
1154616811
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
ME64945 Issued in FL
Legal business name
ELISE CHANG HILLMANN MD PA
Practice address
654 W Indiantown Rd
#103
Jupiter, FL 33458-7546
Phone
(561) 745-8602
Fax
(561) 745-8673
NPI assigned
Jun 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Authorized official

Name
Nicole Hendrickson
Title
Practice Manager
Phone
(561) 745-8602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0900X ME64945 FL Primary

Addresses

Primary practice location

654 W Indiantown Rd
#103
Jupiter, FL 33458-7546

Mailing address

654 W Indiantown Rd
#103
Jupiter, FL 33458-7546
Phone (561) 745-8602

Other identifiers 1

IdentifierTypeStateIssuer
1154616811OtherFLNPI

National Provider Directory

National Provider Directory

Locations

654 W Indiantown Rd
Ste 103
Jupiter, FL 33458
Phone (561) 745-8602

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1154616811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 W INDIANTOWN RD",
            "address_2": "#103",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587546",
            "telephone_number": "561-745-8602",
            "fax_number": "561-745-8673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 W INDIANTOWN RD",
            "address_2": "#103",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587546",
            "telephone_number": "561-745-8602",
            "fax_number": "561-745-8673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELISE CHANG HILLMANN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "HENDRICKSON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "561-745-8602"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "FL",
            "license": "ME64945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1154616811",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.