Individual provider Active NPI

Andrew Hilty, FNP

  • Family Nurse Practitioner
  • Lewiston, ME
National Provider Identifier
1568846236
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP151032 Issued in ME
Practice address
57 Birch St
Lewiston, ME 04240
Phone
(207) 753-5400
Fax
(207) 786-0489
NPI assigned
Jul 13, 2015
Last updated
Jul 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60555984 WA
Family Nurse Practitioner 363LF0000X AP60555984 WA
Family Nurse Practitioner 363LF0000X CNP151032 ME Primary

Addresses

Primary practice location

57 Birch St
Lewiston, ME 04240

Mailing address

PO Box 7291
Lewiston, ME 04243-7291
Phone (207) 777-8553

Other practice location 1

12 S 8th St
Yakima, WA 98901-3020
Phone (509) 454-4143

Other identifiers 1

IdentifierTypeStateIssuer
2046562MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20180723002423 ME Practitioner - Nurse Practitioner 0547560138 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP60555984WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Clinical Services, Inc. CurrentSince Jun 18, 2018 Accepting new patients
Community Clinical Services, Inc CurrentSince Jun 18, 2018 Accepting new patients

Locations

100 Campus Ave
Ste 208
Lewiston, ME 04240
Phone (207) 777-8974

106 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3383

57 Birch St
Lewiston, ME 04240
Phone (207) 344-9221

57 Birch St
Ste 102
Lewiston, ME 04240
Phone (207) 753-5400

Organizations & group practices 2

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": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1568846236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7291",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042437291",
            "telephone_number": "207-777-8553",
            "fax_number": "207-777-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 BIRCH ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "04240",
            "telephone_number": "207-753-5400",
            "fax_number": "207-786-0489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 S 8th St",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989013020",
            "country_code": "US",
            "telephone_number": "509-454-4143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILTY",
        "first_name": "ANDREW",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-13",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60555984",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60555984",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP151032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2046562",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.