Jezzarae Rose Hedlund, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD60297939 Issued in WA

Practice address

521 W Garland Ave
Spokane, WA 99205-2954

Phone

(509) 327-9505

Fax

(509) 325-3277

NPI assigned

Jul 16, 2012

Last updated

Mar 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Garland Vision Source IncGroup PAC ID 8123139425, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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

• Garland Vision Source, Inc.

  • Optometrist
  • Spokane, WA
  • NPI 1992986327
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1225383268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 W GARLAND AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992052954",
            "telephone_number": "509-327-9505",
            "fax_number": "509-325-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 W GARLAND AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992052954",
            "telephone_number": "509-327-9505",
            "fax_number": "509-325-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDLUND",
        "first_name": "JEZZARAE",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60297939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2044675",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G8925180",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey G Hedge, D.O
• Katlynn N Hedgecock, DPT
• Clinton S Hedges, PA-C
• Karin Ann Hedges
• Kyle Allen Hedges
• Shawna Brittney Hedquist, MA, NCC, LMHC
• Maria-Ximena Hedrick, RD
• Mary Hedrick, PA
• Sarah Anne Hedrick
• Heather Hedum, CDP

• Optometrist in Spokane, WA
• Providers in Spokane, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.