Individual provider Active NPI

Nicholaus Jack Hilliard, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
National Provider Identifier
1619170552
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME101330 Issued in FL
Practice address
5149 N 9TH Ave
Pensacola, FL 32504-8779
Phone
(850) 416-6303
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X 25024 AL
Hematology (Pathology) Physician 207ZH0000X ME 101330 FL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 101330 FL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME101330 FL Primary

Addresses

Primary practice location

5149 N 9TH Ave
Pensacola, FL 32504-8779

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 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
I20090817000267 FL Practitioner - Pathology 5092869677 Reassigns benefits to 2 organizations
I20160208001991 AL Practitioner - Pathology 5092869677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Alabama School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vivid Pathology PAGroup PAC ID 9133106784, 12 clinicians

Practice addresses (Care Compare)

123 Baptist Way
Pensacola, FL 32503-2254
Phone (448) 227-5201

1301 Belleville Ave
Brewton, AL 36426-1306
Phone (251) 867-8061

2600 Hospital Dr
Bonifay, FL 32425-4264
Phone (850) 416-6484

3801 E Hwy 98
Port Saint Joe, FL 32456-5318
Phone (850) 229-5600

4900 Bayou Blvd
Suite 204
Pensacola, FL 32503-2533
Phone (866) 697-8378

5151 N 9TH Ave
Pensacola, FL 32504-8721
Phone (850) 416-6484

6002 Berryhill Rd
Milton, FL 32570-5062
Phone (850) 416-6484

7800 US Hwy 98 W
Miramar Beach, FL 32550-7228
Phone (850) 416-6484

8333 N Davis Hwy
Pensacola, FL 32514-6050
Phone (850) 474-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
76.67
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25024ALMDDermatopathology (Pathology) Physician
ME 101330FLMDHematology (Pathology) Physician
101330FLMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vivid Pathology PA Anatomic Pathology & Clinical Pathology Current Accepting new patients
Vivid Pathology PA Dermatopathology CurrentSince Jul 14, 2012 Accepting new patients
DW McMillan Memorial Hospital Current Accepting new patients
DW McMillan Memorial Hospital Current Accepting new patients
West Florida Medical Center Clinic, PA CurrentSince May 16, 2009 Accepting new patients
West Florida Medical Center Clinic PA Past Accepting new patients
Vivid Pathology PA Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

849 S Three Notch St
Andalusia, AL 36420
Phone (334) 222-6953

1301 Belleville Ave
Brewton, AL 36426
Phone (251) 809-8439

2600 Hospital Dr
Bonifay, FL 32425
Phone (850) 416-6484

8333 N Davis Hwy
Pensacola, FL 32514
Phone (850) 474-8000

1000 W Moreno St
Pensacola, FL 32501
Phone (850) 434-4011

5149 N 9th Ave
Ste 122
Pensacola, FL 32504
Phone (843) 518-2854

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

3801 E Highway 98
Port St Joe, FL 32456
Phone (850) 229-5600

5700 Southwyck Blvd
Toledo, OH 43614

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1619170552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5149 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048779",
            "telephone_number": "850-416-6303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLIARD",
        "first_name": "NICHOLAUS",
        "middle_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "AL",
            "license": "25024",
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "FL",
            "license": "ME 101330",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "101330",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME101330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.