Individual provider Active NPI

Rachel Hildebrand

  • Pediatrics Physician
  • Blaine, MN
National Provider Identifier
1235670456
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
67575 Issued in MN
Practice address
11855 Ulysses St NE
Blaine, MN 55434
Phone
(763) 581-0555
Fax
(763) 581-0556
NPI assigned
Mar 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 67575 MN Primary

Addresses

Primary practice location

11855 Ulysses St NE
Blaine, MN 55434

Mailing address

11855 Ulysses St NE
Blaine, MN 55434-3947
Phone (763) 581-0555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200813002843 MN Practitioner - Pediatric Medicine 5193097681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-5400

4181 108TH Ave NE
Blaine, MN 55449-7439
Phone (651) 430-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
67575MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Memorial Health Care Current Accepting new patients
North Memorial Health Care CurrentSince Sep 1, 2020 Accepting new patients
North Memorial Health Care CurrentSince Sep 1, 2020 Accepting new patients

Locations

4181 108th Ave NE
Blaine, MN 55449
Phone (763) 581-0555

9855 Hospital Dr
Ste 102A
Maple Grove, MN 55369
Phone (763) 581-9220

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

Interoperability endpoints

  • Direct secure messaging: rhildebrand161629@direct.northmemorial.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1235670456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11855 ULYSSES ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343947",
            "telephone_number": "763-581-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11855 ULYSSES ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55434",
            "telephone_number": "763-581-0555",
            "fax_number": "763-581-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDEBRAND",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "67575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.