STEPHEN A HILTY M.D.
NPI 1205839818
Internal Medicine in San Luis Obispo, CA

Q: What is Stephen Hilty's NPI number?

The NPI number for Stephen Hilty is 1205839818. It was assigned to this individual provider in the NPPES registry on May 27, 2005.

Q: What is Stephen Hilty's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Stephen Hilty was last updated on September 22, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 27, 2005PECOS EnrolledAccepts Medicare AssignmentCLIA 05D0952676 · Microscopy

97.95/100

CMS Quality Rating

148 CASA ST, SAN LUIS OBISPO, CA 93405(805) 543-8310(805) 543-1103 Get Directions Write a Review

NPPES record last updated: September 22, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Stephen A Hilty M.d. NPPES

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

STEPHEN A HILTY M.D. (NPI 1205839818) is an individual internal medicine provider in San Luis Obispo, California, licensed in California (A061885) and active in the NPI registry since May 2005. He is enrolled in Medicare PECOS, holds a CLIA Microscopy certificate valid through October 18, 2026, and is a graduate of Geisel School Of Medicine At Dartmouth (1995).

NPPES Registry Identity

NPI1205839818

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameSTEPHEN A HILTYCredential: M.D.

Location Address148 CASA STSan Luis Obispo, CA 93405-1804

Mailing Address148 Casa StSan Luis Obispo, CA 93405-1804 · (805) 543-8310 · Fax (805) 543-1103

Phone(805) 543-8310

Fax(805) 543-1103

Sole ProprietorYes

Medical School CMSGeisel School Of Medicine At DartmouthGraduated 1995

Enumeration DateMay 27, 2005

Last NPPES UpdateSeptember 22, 2011

✔ NPI 1205839818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in CA · A061885

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

148 CASA ST, San Luis Obispo, CA 93405

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Other Identifiers 3

Medicaid00A618850CA

Medicare PINA61885CA

Medicare UPING69980

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Stephen A Hilty M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9234286980

PECOS Enrollment IDI20090415000177

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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0952676

Stephen A Hilty MD · San Luis Obispo, CA

Active · expires Oct 18, 2026

CLIA Number05D0952676

Laboratory TypePhysician Office

Certificate Effective DateOctober 19, 2024

Certificate Expiration DateOctober 18, 2026

Laboratory DirectorStephen A. Hilty MD

Laboratory Phone(805) 543-8310

Laboratory LocationStephen A Hilty MD148 Casa Street, San Luis Obispo, CA 93405

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Areas of Expertise CMS Part B claims 11

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.

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.

181 services181 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.

129 services66 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

125 services125 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

124 services124 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.

122 services82 patients

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.

105 services68 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

62 services51 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

58 services58 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

58 services58 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

33 services25 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93405 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

$135.73 typical visit price

range $59.84 – $178.89

Typical copayment $33.93 (range $14.96 – $44.72)

Most-billed visit code 99204

Established Patient

$104.82 typical visit price

range $19.70 – $146.55

Typical copayment $26.20 (range $4.92 – $36.63)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.95/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

96.27

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Advance Care Plan

99%243 patients4/55-star benchmark: 100%

Breast Cancer Screening

84%61 patients4/55-star benchmark: 93%

Colorectal Cancer Screening

91%146 patients5/55-star benchmark: 88%

Controlling High Blood Pressure

95%73 patients5/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

96%782 patients4/55-star benchmark: 100%

e-Prescribing

100%434 patients5/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

99%135 patients4/55-star benchmark: 100%

Screening for Osteoporosis for Women Aged 65-85 Years of Age

78%65 patients4/55-star benchmark: 98%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 17

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

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

DME-Orthotic Devices · category DF010N

1 supplier11 claims220 services$4.92 avg. paid by Medicare

Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each A4390

DME-Orthotic Devices · category DF010N

1 supplier11 claims220 services$9.27 avg. paid by Medicare

Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce A4394

DME-Orthotic Devices · category DF010N

1 supplier11 claims264 services$2.50 avg. paid by Medicare

Adhesive remover, wipes, any type, each A4456

DME-Medical/Surgical Supplies · category DA000N

1 supplier11 claims550 services$0.23 avg. paid by Medicare

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