NPIMap

Individual provider Active NPI

Jonathan Hedrick

  • Family Medicine Physician
  • Roseville, CA
National Provider Identifier
1417342106
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A157270 Issued in CA
Practice address
3100 Douglas Blvd
Roseville, CA 95661-3866
Phone
(916) 774-8300
NPI assigned
Mar 31, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A157270 CA Primary

Addresses

Primary practice location

3100 Douglas Blvd
Roseville, CA 95661-3866

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210831000885 NC Practitioner - Family Practice 7012200793 Reassigns benefits to 1 organization
I20220818000315 CA Practitioner - Family Practice 7012200793 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

3100 Douglas Blvd
Roseville, CA 95661-3866
Phone (916) 774-8500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A157270CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Sep 7, 2021 Accepting new patients
Tahoe Forest Hospital District Family Medicine CurrentSince Jul 25, 2022 Accepting new patients
Tahoe Forest Hospital District Current Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Sep 7, 2021 Accepting new patients
Sutter Valley Medical Foundation Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Aug 1, 2023 Accepting new patients
Tahoe Forest Hospital District CurrentSince Jul 25, 2022 Accepting new patients
Sutter Valley Medical Foundation Family Medicine Current Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine Current Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

3100 Douglas Blvd
Roseville, CA 95661
Phone (916) 774-8300

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

10051 Lake Ave
Ste 3
Truckee, CA 96161
Phone (530) 587-7461

10956 Donner Pass Rd
Ste 230
Truckee, CA 96161
Phone (530) 582-3277

10121 Pine Ave
Truckee, CA 96161
Phone (530) 582-3220

10956 Donner Pass Rd
Ste 110
Truckee, CA 96161
Phone (530) 581-8864

1901 Hillandale Rd
Ste D
Durham, NC 27705
Phone (919) 383-4355

200 Park At North Hills St
Ste 100
Raleigh, NC 27609
Phone (919) 890-8868

Organizations & group practices 10

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 5

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": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1417342106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 DOUGLAS BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613866",
            "telephone_number": "916-774-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDRICK",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-31",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A157270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.