Gail Hegeman, PH D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP2464 Issued in MN

Practice address

1711 County Road B West
Suite 144S
Roseville, MN 55113-4100

Phone

(651) 635-0909

Fax

(612) 822-8669

NPI assigned

Aug 25, 2005

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Dr. Gail M Hegeman Professional name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1114910049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 COUNTY ROAD B WEST",
            "address_2": "SUITE 144S",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134100",
            "telephone_number": "651-635-0909",
            "fax_number": "612-822-8669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 COUNTY ROAD B WEST",
            "address_2": "SUITE 144S",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134100",
            "telephone_number": "651-635-0909",
            "fax_number": "612-822-8669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEGEMAN",
        "first_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "PH D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-25",
        "last_updated": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP2464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIOR HEALTH",
            "identifier": "30269000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "59123AR",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "59125HE",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "642047800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "6113193",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAIL",
            "last_name": "HEGEMAN",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "PH D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Psychologist in Roseville, MN
• Providers in Roseville, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.