Individual provider Active NPI

Matthew Robert Hileman, OD

  • Optometrist
  • Saint Helena, CA
National Provider Identifier
1477559011
Registry record updated Sep 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11888 Issued in CA
Practice address
1104 Adams St
Ste 101
Saint Helena, CA 94574-1165
Phone
(707) 963-7923
Fax
(707) 963-8653
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11888 CA Primary

Addresses

Primary practice location

1104 Adams St
Ste 101
Saint Helena, CA 94574-1165

Mailing address

1104 Adams St
Ste 101
Saint Helena, CA 94574-1165
Phone (707) 963-7923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317001335 CA Practitioner - Optometry 8729977004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1104 Adams St
Suite 101
Saint Helena, CA 94574-1165
Phone (707) 963-7923

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Clearlake Hospital Inc. CurrentSince Nov 12, 2025 Accepting new patients
Matthew R Hileman, O D a Profesional Corporation Optometrist CurrentSince May 15, 2003 Accepting new patients
Adventist Health Clearlake Hospital, Inc Past Accepting new patients

Locations

15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820

18990 Coyote Valley Rd
Ste 10
Hidden Valley Lake, CA 95467
Phone (707) 987-8344

487 S Main St
Lakeport, CA 95453
Phone (707) 263-4360

1104 Adams St
Ste 101
Saint Helena, CA 94574
Phone (707) 963-7923

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222732800000",
    "number": "1477559011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 ADAMS ST",
            "address_2": "STE 101",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945741165",
            "telephone_number": "707-963-7923",
            "fax_number": "707-963-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 ADAMS ST",
            "address_2": "STE 101",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945741165",
            "telephone_number": "707-963-7923",
            "fax_number": "707-963-8653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILEMAN",
        "first_name": "MATTHEW",
        "middle_name": "ROBERT",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2008-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Helena, CA

Sources for this page

Verify at the official NPI Registry.