NPIMap

Individual provider Active NPI

Blake W Hildahl, M.D.

  • Orthopaedic Surgery Physician
  • Eagan, MN
National Provider Identifier
1881972016
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
57601 Issued in WI
Practice address
2620 Eagan Woods Dr Ste 100
Eagan, MN 55121-1138
Phone
(651) 968-5200
Fax
(651) 968-5204
NPI assigned
Jul 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 57601 WI Primary

Addresses

Primary practice location

2620 Eagan Woods Dr Ste 100
Eagan, MN 55121-1138

Mailing address

710 Commerce Dr
Suite 200
Woodbury, MN 55125-0001
Phone (651) 968-5200

Other practice location 1

Uw Hospital and Clinics
600 Highland Ave, H4/831
Madison, WI 53792-0001
Phone (608) 265-9174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200212001735 WI Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 3072746593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
Medical College of Wisconsin, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hand to Shoulder Center of Wisconsin, LTD.Group PAC ID 6901884337, 34 clinicians

Practice addresses (Care Compare)

2323 N Casaloma Dr
Appleton, WI 54913-8284
Phone (920) 730-8833

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57601WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hand to Shoulder Center of Wisconsin, LTD. CurrentSince Mar 1, 2020 Accepting new patients
Hand to Shoulder Center of Wisconsin, LTD. Hand Surgery CurrentSince Mar 1, 2020 Accepting new patients

Locations

2323 N Casaloma Dr
Appleton, WI 54913

1551 Park Pl
Green Bay, WI 54304
Phone (773) 551-9490

1551 Park Pl
Ste 100
Green Bay, WI 54304

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BIBACA

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 and National Provider Directory roles.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1881972016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR",
            "address_2": "SUITE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551250001",
            "telephone_number": "651-968-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 EAGAN WOODS DR STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211138",
            "telephone_number": "651-968-5200",
            "fax_number": "651-968-5204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Uw Hospital and Clinics",
            "address_2": "600 Highland Ave, H4/831",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537920001",
            "country_code": "US",
            "telephone_number": "608-265-9174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILDAHL",
        "first_name": "BLAKE",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-21",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "57601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.