Kristin Anne Hildebrandt, MD
Individual provider Active NPI Family Medicine Physician · Mountain Home, ID
NPI 1962961359 · NPPES record last updated Sep 19, 2025
Key facts
- NPI
- 1962961359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 3571057 (ID)
- Practice address
- 465 McKenna Dr
Mountain Home, ID 83647-2143 - Phone
- (208) 587-9703
- Fax
- (208) 587-1816
- NPI assigned
- Mar 15, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Health Centers
St Lukes Clinic-Treasure Valley LLC
Okanogan County Public Hospital District No. 3
Rural Physicians Group-Pannu PLLC
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
- St Luke'S Elmore Medical Center
- St Luke'S Regional Medical Center
- Mid Valley Hospital & Clinic
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WA, ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220826002572 | WA | Practitioner - Family Practice |
0547591646 | Reassigns benefits to 2 organizations |
| I20250712000272 | ID | Practitioner - Family Practice | 0547591646 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3571057 | ID | MD | Family Medicine Physician |
| 61181074 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Family Medicine | Current |
Accepting new patients |
| Family Health Centers | Current |
Accepting new patients | |
| Okanogan County Public Hospital District No. 3 | Current |
Accepting new patients | |
| Family Health Centers | Current | Accepting new patients | |
| Rural Physicians Group-Pannu PLLC | Family Medicine | Current | Accepting new patients |
| Family Health Centers | Current |
Accepting new patients | |
| St Lukes Clinic-Treasure Valley LLC | Family Medicine | Current |
Accepting new patients |
| Rural Physicians Group-Pannu PLLC | Family Medicine | Current |
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) 381-2378
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
895 N 6th E
Mtn Home, ID 83647
Phone (208) 580-2661
465 McKenna Dr
Mtn Home, ID 83647
Phone (208) 587-9703
525 Jay Ave
Brewster, WA 98812
Phone (509) 689-3455
810 Jasmine St
Omak, WA 98841
Phone (509) 826-1760
1003 Koala Dr
Omak, WA 98841
Phone (509) 422-1913
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 61181074 | WA | |
| Family Medicine Physician | 207Q00000X | 3571057 | ID | Yes |
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
1003 Koala Dr
Omak, WA 98841-9247
Phone (800) 660-2129
Other practice location 2
895 N 6th E
Mountain Home, ID 83647-2207
Phone (208) 587-8401
NPI Registry JSON
{
"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": "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"
},
{
"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"
}
],
"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
- Robert Terry Hall
- Sable C Hart
- Bany Hegler
- Crystal Herrera
- Saad Hijazi
- Christine Elizabeth Hobbs
- Jacob Hohenshelt
- Kyle Hollenback
- Joseph Wells Hoskin
- HSC Dental LLC
All providers in Mountain Home, ID · Family Medicine Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.