Individual provider Active NPI

Paul Benjamin Hilfer, DDS

  • Endodontics
  • Mankato, MN
National Provider Identifier
1891782603
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D11763 Issued in MN
Practice address
1570 Adams St
Mankato, MN 56001-5192
Phone
(507) 386-0288
NPI assigned
Oct 6, 2005
Last updated
Apr 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X D11763 MN Primary
Endodontics 1223E0200X 6870 NE

Addresses

Primary practice location

1570 Adams St
Mankato, MN 56001-5192

Mailing address

1570 Adams St
Mankato, MN 56001-5192
Phone (507) 386-0288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150611002580 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0749501013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D11763MNMDEndodontist
6870NEMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Minnesota Endodontics LLC Endodontics CurrentSince May 16, 2021 Accepting new patients

Locations

1570 Adams St
Mankato, MN 56001
Phone (507) 386-0288

Organizations & group practices 1

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1891782603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 ADAMS ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015192",
            "telephone_number": "507-386-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 ADAMS ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015192",
            "telephone_number": "507-386-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILFER",
        "first_name": "PAUL",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2021-04-27",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "D11763",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NE",
            "license": "6870",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.