Individual provider Active NPI

Jerry I Hadrych, DPM

  • Podiatrist
  • Fairmont, WV
National Provider Identifier
1124010459
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
320 Issued in WV
Practice address
603 Alta Vista Ave
Fairmont, WV 26554-4185
Phone
(304) 333-3338
Fax
(304) 333-3201
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 320 WV Primary

Addresses

Primary practice location

603 Alta Vista Ave
Fairmont, WV 26554-4185

Mailing address

603 Alta Vista Ave
Fairmont, WV 26554-4185
Phone (304) 333-3338

Other practice location 1

3000 Mon Health Medical Park Dr Ste 3201
Morgantown, WV 26505-1170
Phone (304) 285-1460

Other identifiers 3

IdentifierTypeStateIssuer
01623405MedicaidPA
WV00320OtherWVSTATE
0099983000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100519000423 WV Practitioner - Podiatry 2365571031 Reassigns benefits to 1 organization
Practice locations: Fairmont, WV
O20100930080197 WV DME Supplier - Physician - Podiatry 4385765353 Practice locations: Fairmont, WV

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monongalia County General Hospital CompanyGroup PAC ID 9638073380, 241 clinicians

Practice addresses (Care Compare)

1200 J D Anderson Dr
Morgantown, WV 26505-3494
Phone (304) 598-1200

150 Memorial Dr
Kingwood, WV 26537-1141
Phone (304) 329-1400

3280 University Ave
Suite 3
Morgantown, WV 26505-2266

603 Alta Vista Ave
Fairmont, WV 26554-4185
Phone (304) 333-3338

Hospital & facility affiliations

  • Mon Health Medical Center Hospital, Morgantown, WV, CCN 510024

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue124
Removal of skin lesions1-10
Removal of nail tissue1138
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
320WVMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Monongalia County General Hospital Company CurrentSince Oct 1, 2020 Accepting new patients

Locations

150 Memorial Dr
Kingwood, WV 26537
Phone (304) 329-4701

3000 Mon Health Medical Park Dr
Ste 3201
Morgantown, WV 26505
Phone (304) 285-1460

Interoperability endpoints

  • Direct secure messaging: jhadrych409973@direct.wvuhsdirect.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1124010459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 ALTA VISTA AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265544185",
            "telephone_number": "304-333-3338",
            "fax_number": "304-333-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 ALTA VISTA AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265544185",
            "telephone_number": "304-333-3338",
            "fax_number": "304-333-3201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Mon Health Medical Park Dr Ste 3201",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265051170",
            "country_code": "US",
            "telephone_number": "304-285-1460",
            "fax_number": "304-285-2739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HADRYCH",
        "first_name": "JERRY",
        "middle_name": "I",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WV",
            "license": "320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01623405",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "WV00320",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0099983000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

Verify at the official NPI Registry.