Individual provider Active NPI

Michele Christine Hilberg, CRNP

  • Pediatric Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1184197303
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R211415 Issued in MD
Practice address
707 N Broadway
Baltimore, MD 21205-1832
Phone
(443) 923-9200
NPI assigned
Jan 10, 2019
Last updated
Feb 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R211415 MD Primary

Addresses

Primary practice location

707 N Broadway
Baltimore, MD 21205-1832

Mailing address

121 Graystone Farm Rd
White Hall, MD 21161-9101
Phone (410) 812-8472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190430000473 MD Practitioner - Nurse Practitioner 6608118310 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R211415MDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Krieger Associates CurrentSince Apr 4, 2019 Accepting new patients
Kennedy Krieger Associates CurrentSince Apr 4, 2019 Accepting new patients

Locations

1741 Ashland Ave
Rm 642D
Baltimore, MD 21205

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

Interoperability endpoints

  • Direct secure messaging: mmattson291459@direct.hopkinsmedicine.org
  • Direct secure messaging: mmattson9846@direct.kennedykrieger.org

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": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1184197303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 GRAYSTONE FARM RD",
            "city": "WHITE HALL",
            "state": "MD",
            "postal_code": "211619101",
            "telephone_number": "410-812-8472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051832",
            "telephone_number": "443-923-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILBERG",
        "first_name": "MICHELE",
        "middle_name": "CHRISTINE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R211415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.