Provider Demographics
NPI:1295700441
Name:DR R HILLSMAN MD PC
Entity type:Organization
Organization Name:DR R HILLSMAN MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:ONIE
Authorized Official - Last Name:HILLSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-729-6335
Mailing Address - Street 1:1771 POST RD E
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5606
Mailing Address - Country:US
Mailing Address - Phone:203-803-0238
Mailing Address - Fax:
Practice Address - Street 1:2 POMPERAUG OFFICE PARK STE 308
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-2293
Practice Address - Country:US
Practice Address - Phone:203-586-1181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT021015207XX0004X, 207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
44337OtherMD HEALTH PLAN
ZS054OtherOXFORD HEALTH PLAN
0R0504OtherPHS
83988OtherUS HEALTHCARE
A89105OtherMEDSPAN
CT2108419OtherAETNA
200000306OtherRAILROAD MEDICARE
799988OtherCONNECTICARE
A89105OtherMEDSPAN
83988OtherUS HEALTHCARE