Individual provider Active NPI

Joseph Francis Hederman, M. D.

  • Internal Medicine Physician
  • Staten Island, NY
National Provider Identifier
1457349185
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
151139 Issued in NY
Practice address
2627 Hylan Boulevard
Suite C
Staten Island, NY 10306-4344
Phone
(718) 351-1136
Fax
(718) 667-9711
NPI assigned
Oct 6, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 151139 NY Primary

Addresses

Primary practice location

2627 Hylan Boulevard
Suite C
Staten Island, NY 10306-4344

Mailing address

2627 Hylan Boulevard
Suite C
Staten Island, NY 10306-4344
Phone (718) 351-1136

Other identifiers 1

IdentifierTypeStateIssuer
01149366MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040322000488 NY Practitioner - Internal MedicinePractitioner - Emergency Medicine 1456242429

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York Downstate Medical Center, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2627 Hylan Blvd
Suite C
Staten Island, NY 10306-4344

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
72.16 of 100Reported as group
Quality
39.71
Improvement activities
40
Cost
67.57

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Island Medical Specialists, P.L.L.C. Internal Medicine CurrentSince Feb 1, 2004 Accepting new patients
Staten Island University Hospital Past Accepting new patients

Locations

191 Bradley Ave
Staten Island, NY 10314
Phone (516) 558-3010

347 Edison St
Staten Island, NY 10306
Phone (718) 351-1136

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

97 New Dorp Ln
Ste A
Staten Island, NY 10306

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jhederman66179@northwell.direct-ci.com
  • Direct secure messaging: josephhederman@imspllc.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1457349185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 HYLAN BOULEVARD",
            "address_2": "SUITE C",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103064344",
            "telephone_number": "718-351-1136",
            "fax_number": "718-667-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 HYLAN BOULEVARD",
            "address_2": "SUITE C",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103064344",
            "telephone_number": "718-351-1136",
            "fax_number": "718-667-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDERMAN",
        "first_name": "JOSEPH",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2023-03-07",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "151139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01149366",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.