Individual provider Active NPI

Linda Kozel Hegstrand, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
National Provider Identifier
1457384687
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4301063871 Issued in MI
Practice address
2426 Burton St SE
Grand Rapids, MI 49546-4898
Phone
(616) 464-0470
Fax
(205) 350-1428
NPI assigned
Jul 9, 2006
Last updated
May 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301063871 MI
Physical Medicine & Rehabilitation Physician 208100000X 4301063871 MI Primary

Addresses

Primary practice location

2426 Burton St SE
Grand Rapids, MI 49546-4898

Mailing address

1125 Conlon Ave SE
Grand Rapids, MI 49506-3566
Phone (616) 942-6584

Other practice location 1

3097 29th St SE
Grand Rapids, MI 49512-1726
Phone (616) 741-2232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200702001795 MI Practitioner - General Practice 3870915564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of Wisconsin School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3097 29TH St SE
Suite B
Grand Rapids, MI 49512-1726
Phone (616) 741-2232

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301063871MIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golan Integrated Physical Medicine Physical Medicine & Rehabilitation CurrentSince Jun 1, 2020 Accepting new patients
Golan Integrated Physical Medicine CurrentSince Nov 13, 2022 Accepting new patients
Innovation Health and Spine Physical Medicine & Rehabilitation Past Accepting new patients

Locations

3097 29th St SE
Grand Rapids, MI 49512
Phone (616) 741-2232

3097 29th St SE
Ste B
Grand Rapids, MI 49512
Phone (616) 741-2232

603 N Waverly Rd
Ste 6
Lansing, MI 48917
Phone (517) 321-8568

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1457384687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 CONLON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495063566",
            "telephone_number": "616-942-6584",
            "fax_number": "206-350-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2426 BURTON ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495464898",
            "telephone_number": "616-464-0470",
            "fax_number": "205-350-1428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3097 29th St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495121726",
            "country_code": "US",
            "telephone_number": "616-741-2232",
            "fax_number": "877-866-2053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEGSTRAND",
        "first_name": "LINDA",
        "middle_name": "KOZEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301063871",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301063871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.