Individual provider Active NPI

Chad Michael Hillyer, PA-C

  • Dermatology Physician
  • Elkhorn, NE
National Provider Identifier
1902825904
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
1041 Issued in NE
Practice address
1408 Veterans Dr
Ste 100
Elkhorn, NE 68022-6912
Phone
(402) 916-5665
Fax
(402) 934-2719
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 1041 NE Primary

Addresses

Primary practice location

1408 Veterans Dr
Ste 100
Elkhorn, NE 68022-6912

Mailing address

1408 Veterans Dr
Ste 100
Elkhorn, NE 68022-6912
Phone (402) 916-5665

Other identifiers 1

IdentifierTypeStateIssuer
P01022462OtherNERR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20040315001067 NE Practitioner - Physician Assistant 0143115667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin PC 3 clinicians

Practice addresses (Care Compare)

1408 Veterans Dr
Suite 100
Elkhorn, NE 68022-6912
Phone (402) 916-5665

Merit-based Incentive Payment System (MIPS)

Final score
88.6 of 100Reported as individual
Quality
77.2
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1041NEMDMental Health Counselor
001538IAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skin PC Dermatology CurrentSince Jun 1, 2011 Accepting new patients
Rebound Outpatient Therapy PastSince Mar 8, 2005 Accepting new patients
Midamerican Center for Orthopedics Past Accepting new patients
Dan Samani MD PC Past Accepting new patients
Visiting Nurse Health Services Past Accepting new patients
Physician Homecare Associates Past Accepting new patients

Locations

1408 Veterans Dr
Ste 100
Elkhorn, NE 68022
Phone (402) 916-5664

410 E 22nd St
Ste 1
Fremont, NE 68025
Phone (402) 719-7152

Organizations & group practices 6

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1902825904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 VETERANS DR",
            "address_2": "STE 100",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680226912",
            "telephone_number": "402-916-5665",
            "fax_number": "402-934-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 VETERANS DR",
            "address_2": "STE 100",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680226912",
            "telephone_number": "402-916-5665",
            "fax_number": "402-934-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLYER",
        "first_name": "CHAD",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NE",
            "license": "1041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01022462",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, NE

Sources for this page

Verify at the official NPI Registry.