Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. JOHN EDWIN HILSABECK M.D.
NPI 1174503957
Family Medicine in Spencer, IA

Q: What is John Hilsabeck's NPI number?

The NPI number for John Hilsabeck is 1174503957. It was assigned to this individual provider in the NPPES registry on January 18, 2006.

Q: What is John Hilsabeck's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for John Hilsabeck was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 18, 2006PECOS Enrolled

116 E 11TH ST, SUITE 101, SPENCER, IA 51301(712) 264-3500(712) 264-3535 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. John Edwin Hilsabeck M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOHN EDWIN HILSABECK M.D. (NPI 1174503957) is an individual family medicine provider in Spencer, Iowa, licensed in Iowa (24991) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Spencer Municipal Hospital, and is a graduate of University Of Iowa, Rj & L Carver College Of Medicine (1984).

NPPES Registry Identity

NPI1174503957

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. JOHN EDWIN HILSABECKCredential: M.D.

Location Address116 E 11TH ST, SUITE 101Spencer, IA 51301-4364

Mailing Address116 E 11th St, Suite 101Spencer, IA 51301-4364 · (712) 264-3500 · Fax (712) 264-3535

Phone(712) 264-3500

Fax(712) 264-3535

Sole ProprietorNo

Medical School CMSUniversity Of Iowa, Rj & L Carver College Of MedicineGraduated 1984

Enumeration DateJanuary 18, 2006

Last NPPES UpdateJuly 13, 2026

✔ NPI 1174503957 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IA · 24991

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

116 E 11TH ST, Spencer, IA 51301

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Other Identifiers 1

Medicaid4034850IA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Avera Health Plans, Medica, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. John Edwin Hilsabeck M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9234268467

PECOS Enrollment IDI20100527000084

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

471 services280 patients

Anticoagulant management of patient taking warfarin 93793

Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.

464 services30 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

285 services186 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

107 services92 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

97 services97 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

95 services95 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Spencer Municipal Hospital

Acute Care Hospitals · Spencer, IA

5/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number160112

Location1200 1st Avenue EastSpencer, IA 51301 · Clay County

Emergency services Birthing friendly

Lakes Regional Healthcare

Acute Care Hospitals · Spirit Lake, IA

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number160124

Location2301 Highway 71Spirit Lake, IA 51360 · Dickinson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 51301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.84 typical visit price

range $52.96 – $161.40

Typical copayment $20.46 (range $13.24 – $40.35)

Most-billed visit code 99203

Established Patient

$94.05 typical visit price

range $16.91 – $131.98

Typical copayment $23.51 (range $4.22 – $32.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 31

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

10 suppliers142 claims304 services$5.81 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers41 claims53 services$1.01 avg. paid by Medicare

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

1 supplier12 claims720 services$1.12 avg. paid by Medicare

Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each A4373

DME-Orthotic Devices · category DF010N

1 supplier13 claims130 services$5.27 avg. paid by Medicare

Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385

DME-Orthotic Devices · category DF010N

1 supplier12 claims120 services$4.51 avg. paid by Medicare

Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each A4425

DME-Orthotic Devices · category DF010N

1 supplier12 claims120 services$3.17 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

7 suppliers87 claims87 services$41.67 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

2 suppliers22 claims44 services$1.75 avg. paid by Medicare

Small volume nonfiltered pneumatic nebulizer, disposable A7004

DME-Other DME · category DE000N

1 supplier11 claims22 services$1.44 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

3 suppliers45 claims45 services$116.03 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

3 suppliers56 claims143 services$42.53 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

3 suppliers38 claims225 services$24.29 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

6 suppliers30 claims174 services$16.01 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

7 suppliers64 claims64 services$73.02 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

9 suppliers76 claims76 services$24.59 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

2 suppliers16 claims16 services$22.54 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

7 suppliers108 claims611 services$3.08 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

6 suppliers47 claims47 services$13.90 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier18 claims18 services$17.83 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0471

DME-Other DME · category DE001N

1 supplier17 claims17 services$284.31 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

1 supplier77 claims77 services$17.08 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier43 claims43 services$7.21 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers100 claims100 services$48.16 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

4 suppliers108 claims108 services$111.29 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier33 claims33 services$35.11 avg. paid by Medicare

Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606

DME-Drugs Administered Through DME · category DG006N

2 suppliers14 claims840 services$6.19 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

4 suppliers22 claims4,179 services$0.02 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

3 suppliers35 claims2,190 services$0.09 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

5 suppliers40 claims2,370 services$0.78 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

3 suppliers62 claims66 services$194.06 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

7 suppliers64 claims64 services$22.80 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHI KAE HECKERT CNP

Nurse Practitioner (Family)

116 E 11TH ST, STE 101
SPENCER, IA 51301

Clay County (712) 264-3500

SARA CASEY ARNP

Nurse Practitioner

116 E 11TH ST
SPENCER, IA 51301

Clay County (712) 264-3500

PHYSICIANS LABORATORY OF NORTHWEST IOWA LTD

Pathology (Anatomic Pathology & Clinical Pathology)

116 E 11TH ST, SUITE 204
SPENCER, IA 51301

Clay County (712) 262-3795

TRAVIS J. WITT M.D.

Family Medicine

116 E 11TH ST, SUITE 101
SPENCER, IA 51301

Clay County (712) 264-3500

DR. DAVID PAUL ROBISON D.O.

Family Medicine

116 E 11TH ST, SUITE 101
SPENCER, IA 51301

Clay County (712) 264-3500

MERCY HEALTH SERVICES-IOWA CORP.

Pharmacy (Community/Retail Pharmacy)

116 E 11TH ST
SPENCER, IA 51301

Clay County (712) 262-2343

DR. RONALD JAMES CRESWELL M.D.

Family Medicine

116 E 11TH ST, SUITE 101
SPENCER, IA 51301

Clay County (712) 264-3500

DR. SONIA ALBERTSON SATHER M.D.

Family Medicine

116 E 11TH ST, SUITE 101
SPENCER, IA 51301

Clay County (712) 264-3500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Hilsabeck's NPI number?

The NPI number for John Hilsabeck is 1174503957. It was assigned to this individual provider in the NPPES registry on January 18, 2006.

Where is John Hilsabeck located?

John Hilsabeck practices at 116 E 11th St Suite 101, Spencer, IA 51301. The listed phone number is (712) 264-3500.

What is John Hilsabeck's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is John Hilsabeck enrolled in Medicare?

Yes. John Hilsabeck is registered in the Medicare PECOS enrollment system.

What insurance does John Hilsabeck accept?

Health plans from Avera Health Plans, Medica and Sanford Health Plan list John Hilsabeck as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is John Hilsabeck affiliated with any hospitals?

According to CMS data, John Hilsabeck is affiliated with Spencer Municipal Hospital and Lakes Regional Healthcare.

When was this NPI record last updated?

The NPPES record for John Hilsabeck was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.