Provider Demographics
NPI:1770561946
Name:HILLEBRAND, DONALD J (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:J
Last Name:HILLEBRAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400S
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131
Mailing Address - Country:US
Mailing Address - Phone:816-932-4655
Mailing Address - Fax:
Practice Address - Street 1:4320 WORNALL RD STE 240
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5955
Practice Address - Country:US
Practice Address - Phone:816-932-3550
Practice Address - Fax:515-241-4100
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63028207RI0008X
IA28356207RI0008X
MO2021012611207RI0008X, 207RT0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant Hepatology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP01214246OtherRR MEDICARE
IAP01353135OtherRR MEDICARE
CA00A630280Medicaid
IA1770561946Medicaid
CAF03850Medicare UPIN
IA719260537Medicare PIN
IAI22140022Medicare PIN
CAWA63028AMedicare PIN