Individual provider Active NPI

Michael Hilliard, MD

  • Emergency Medicine Physician
  • Fort Sam Houston, TX
National Provider Identifier
1538140397
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
K4705 Issued in TX
Practice address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone
(210) 916-2460
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X K4705 TX Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Mailing address

3851 Roger Brooke Dr
McHe-QD (Credentials)
Fort Sam Houston, TX 78234-4501

Other identifiers 2

IdentifierTypeStateIssuer
166762802MedicaidTX
8J1758OtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040813001143 TX Practitioner - Emergency Medicine 8820061211 Reassigns benefits to 2 organizations
I20220303001615 CA Practitioner - Emergency Medicine 8820061211 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP325KYMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kjcares, PLLC CurrentSince Dec 16, 2025 Accepting new patients
Memorialcare Medical Foundation CurrentSince Jan 23, 2022 Accepting new patients
PVD Urgent Care LLC CurrentSince Oct 12, 2018 Accepting new patients
PVD Urgent Care LLC CurrentSince Oct 12, 2018 Accepting new patients
East Texas Medical Center Healthcare Associates Emergency Medicine Past Accepting new patients
Cloud Health Medical Group of California, P.C. Past Accepting new patients
Louisville Radiology Imaging Consultants, PLLC Past Accepting new patients
Kentuckiana Emergency Physicians, PLLC Emergency Medicine Past Accepting new patients
Kentuckiana Emergency Physicians Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

11420 Warner Ave
Fountain Vly, CA 92708
Phone (714) 549-1300

2450 Louisiana St
Ste 400
Houston, TX 77006
Phone (713) 446-9706

18007 Ih 10 W
San Antonio, TX 78257
Phone (210) 530-1040

Organizations & group practices 9

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1538140397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 ROGER BROOKE DR",
            "address_2": "MCHE-QD (CREDENTIALS)",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLIARD",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "K4705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166762802",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8J1758",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.