Individual provider Active NPI

Parker Hildebrand, PA-C

  • Physician Assistant
  • Chandler, AZ
National Provider Identifier
1467009340
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9201 Issued in AZ
Practice address
2815 E Ocotillo Rd Ste 4
Chandler, AZ 85249-6040
Phone
(480) 781-2964
NPI assigned
Aug 24, 2019
Last updated
Oct 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9201 AZ Primary

Addresses

Primary practice location

2815 E Ocotillo Rd Ste 4
Chandler, AZ 85249-6040

Mailing address

PO Box 6610
Chandler, AZ 85246-6610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220811003296 AZ Practitioner - Physician Assistant 1153704911 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ellsworth Medical Group LLCGroup PAC ID 4082959267, 5 clinicians
Ocotillo Medical Group LLCGroup PAC ID 2567748056, 4 clinicians

Practice addresses (Care Compare)

21323 S Ellsworth Loop Rd
Suite 101
Queen Creek, AZ 85142-9865
Phone (480) 307-8440

2815 E Ocotillo Rd
Suite 4
Chandler, AZ 85249-6040
Phone (480) 926-7800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9201AZMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
QC Valley Medical Centers, LLC Multi-Specialty Past Accepting new patients
Ocotillo Health Centers, LLC Multi-Specialty Past Accepting new patients

Organizations & group practices 5

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": "1566604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1467009340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6610",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 E OCOTILLO RD STE 4",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852496040",
            "telephone_number": "480-781-2964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDEBRAND",
        "first_name": "PARKER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-24",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.