Individual provider Active NPI

Kristin Anne Hildebrandt, MD

  • Family Medicine Physician
  • Mountain Home, ID
National Provider Identifier
1962961359
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3571057 Issued in ID
Practice address
465 McKenna Dr
Mountain Home, ID 83647-2143
Phone
(208) 587-9703
Fax
(208) 587-1816
NPI assigned
Mar 15, 2019
Last updated
Sep 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 61181074 WA
Family Medicine Physician 207Q00000X 3571057 ID Primary

Addresses

Primary practice location

465 McKenna Dr
Mountain Home, ID 83647-2143

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

895 N 6th E
Mountain Home, ID 83647-2207
Phone (208) 587-8401

Other practice location 2

1003 Koala Dr
Omak, WA 98841-9247
Phone (800) 660-2129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 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
I20220826002572 WA Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 0547591646 Reassigns benefits to 2 organizations
I20250712000272 ID Practitioner - Family Practice 0547591646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health CentersGroup PAC ID 9739076217, shared by 6 NPIs, 31 clinicians
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians
Rural Physicians Group-Pannu PLLCGroup PAC ID 0345467486, 141 clinicians

Practice addresses (Care Compare)

1003 Koala Dr
Omak, WA 98841-9247
Phone (509) 422-5700

465 McKenna Dr
Mountain Home, ID 83647-2143
Phone (208) 587-9703

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

716 1St Ave S
Okanogan, WA 98840-9679
Phone (509) 422-5700

810 Jasmine St
Omak, WA 98841-9578
Phone (509) 826-1760

895 N 6TH
Mountain Home, ID 83647-2207
Phone (208) 587-8401

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3571057IDMDFamily Medicine Physician
61181074WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Okanogan County Public Hospital District No. 3 CurrentSince Feb 5, 2024 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince Jun 30, 2025 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince Jun 30, 2025 Accepting new patients
Family Health Centers Current Accepting new patients
Family Health Centers CurrentSince Jan 8, 2024 Accepting new patients
Family Health Centers CurrentSince Jan 8, 2024 Accepting new patients
Rural Physicians Group-Pannu PLLC Family Medicine Current Accepting new patients
Rural Physicians Group-Pannu PLLC Family Medicine CurrentSince Sep 1, 2025 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

5575 Dtc Pkwy
Ste 225
Greenwood Village, CO 80111

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2235

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

465 McKenna Dr
Mtn Home, ID 83647
Phone (208) 587-9703

895 N 6th E
Mtn Home, ID 83647
Phone (208) 580-2661

525 Jay Ave
Brewster, WA 98812
Phone (509) 689-3455

1003 Koala Dr
Omak, WA 98841
Phone (509) 422-1913

810 Jasmine St
Omak, WA 98841
Phone (509) 826-1760

Organizations & group practices 9

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.

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": "1552608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1962961359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 MCKENNA DR",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472143",
            "telephone_number": "208-587-9703",
            "fax_number": "208-587-1816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "895 N 6th E",
            "address_purpose": "LOCATION",
            "city": "Mountain Home",
            "state": "ID",
            "postal_code": "836472207",
            "country_code": "US",
            "telephone_number": "208-587-8401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1003 Koala Dr",
            "address_purpose": "LOCATION",
            "city": "Omak",
            "state": "WA",
            "postal_code": "988419247",
            "country_code": "US",
            "telephone_number": "800-660-2129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILDEBRANDT",
        "first_name": "KRISTIN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-15",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "61181074",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "3571057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, ID

Sources for this page

Verify at the official NPI Registry.