Individual provider Active NPI

Hilda Escobedo, PA-C

  • Surgical Physician Assistant
  • Gardner, MA
National Provider Identifier
1275721334
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA2393 Issued in MA
Practice address
242 Green St
Gardner, MA 01440-1336
Phone
(978) 479-1746
NPI assigned
Oct 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2393 MA
Surgical Physician Assistant 363AS0400X PA2393 MA Primary

Addresses

Primary practice location

242 Green St
Gardner, MA 01440-1336

Mailing address

355 Waverley Oaks Rd Ste 100
Waltham, MA 02452-8480
Phone (781) 314-7600

Other identifiers 1

IdentifierTypeStateIssuer
0005005OtherMAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2393MAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emerson Hospital Past Accepting new patients

Organizations & group practices 1

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": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1275721334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 WAVERLEY OAKS RD STE 100",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528480",
            "telephone_number": "781-314-7600",
            "fax_number": "781-314-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336",
            "telephone_number": "978-479-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCOBEDO",
        "first_name": "HILDA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-12",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "2393",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA2393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0005005",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.