Provider Demographics
NPI:1851493399
Name:HILSEN, JESSE MORTON (MD)
Entity type:Individual
Prefix:DR
First Name:JESSE
Middle Name:MORTON
Last Name:HILSEN
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 1:251 NEW KARNER RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-4627
Mailing Address - Country:US
Mailing Address - Phone:518-482-9900
Mailing Address - Fax:518-288-1282
Practice Address - Street 1:251 NEW KARNER RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-4627
Practice Address - Country:US
Practice Address - Phone:518-482-9900
Practice Address - Fax:518-288-1282
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY99312202D00000X, 2084P0804X, 2084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00476751Medicaid
NY00769291Medicaid
NY00476751Medicaid
NY33-4003Medicare ID - Type Unspecified