Hazem M Sedra, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

47271 Issued in MN

Practice address

213 Labree Ave N Ste 207
Thief River Falls, MN 56701-2022

Phone

(218) 683-5137

Fax

(218) 683-5413

NPI assigned

Jun 23, 2006

Last updated

Apr 1, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Family Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Thief River Falls Medical Center Hospital, Thief River Falls, MN, CCN 241381

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Sedra Medical Clinic PLC

  • Family Medicine Physician
  • Thief River Falls, MN
  • NPI 1972840064
  Medicare reassignment NPD Authorized official
• Sanford Health Network North

  dba Sanford Thief River Falls Medical Center

  • Critical Access Hospital
  • Thief River Falls, MN
  • NPI 1043218753
  Medicare reassignment NPD

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

• Sanford Health Network North

  dba Sanford Thief River Falls Medical Center

  • Critical Access Hospital
  • Thief River Falls, MN
  • NPI 1043218753
  Care Compare affiliation
• Sanford Health Network North

  dba Sanford Behavioral Health Center

  • Psychiatric Hospital
  • Thief River Falls, MN
  • NPI 1790842466
  Care Compare affiliation
• Sanford Health Network North

  dba Sanford Behavioral Health Center Clinic

  • Multi-Specialty Clinic/Center
  • Thief River Falls, MN
  • NPI 1861895906

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1669408753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 LABREE AVE N STE 207",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012022",
            "telephone_number": "218-683-5137",
            "fax_number": "218-683-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 LABREE AVE N STE 207",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012022",
            "telephone_number": "218-683-5137",
            "fax_number": "218-683-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDRA",
        "first_name": "HAZEM",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "47271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS #",
            "identifier": "HP47445",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA #",
            "identifier": "0119356",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE #",
            "identifier": "DA9021042392",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NDBS #",
            "identifier": "24944",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "590610500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO/ARAZ #",
            "identifier": "2211190",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LHS/BANNERHEALTH #",
            "identifier": "37639",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13233",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE #",
            "identifier": "137012",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MNBS #",
            "identifier": "910S0SE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Robert Schake, M.A. LP
• Mark R Schneider, MD
• Emily Jane Schuster, ADC-T
• Evan Cade Sconce, DNP, PMHNP-BC
• Sedra Medical Clinic PLC
• Barbara Ann Seeger
• Mya Seeger, COTA
• Shared Medical Technology, Inc
• Shoptikal LLC (Shopko Optical 4271)
• Panjini M Sivanna, MD

• Family Medicine Physician in Thief River Falls, MN
• Providers in Thief River Falls, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.