Chad Michael Hietschold

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

OS17435 Issued in FL

Practice address

7975 Lake Underhill Rd
Orlando, FL 32822-8202

Phone

(407) 303-6830

NPI assigned

Mar 26, 2018

Last updated

May 31, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622419200000",
    "number": "1528563137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 235",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7975 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228202",
            "telephone_number": "407-303-6830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIETSCHOLD",
        "first_name": "CHAD",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-26",
        "last_updated": "2021-05-31",
        "certification_date": "2021-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "OS17435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528563137",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Hidalgo, D.M.D.
• Michelle Jocelyn Hidalgo, M.D.
• Hidden Potential Florida LLC
• Brooke Elisabeth Hieb, DOM
• Erin Hiesinger
• Emily K Hietschold, PA-C
• Suzanne M Higbie-Long, MA
• Kaitlin M Higby, SLP
• Brooke Higgins, D.O.M
• Christine Higgins, ARNP

• Adult Medicine Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Adult Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.