NPIMap

Individual provider Active NPI

Todd E. Hegstrom, MD

  • Diagnostic Radiology Physician
  • Grand Junction, CO
National Provider Identifier
1669474896
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
DR.0025745 Issued in CO
Practice address
2351 G Rd
Grand Junction, CO 81505-9641
Phone
(970) 644-3237
Fax
(970) 644-3259
NPI assigned
Jun 1, 2005
Last updated
Sep 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X DR.0025745 CO Primary

Addresses

Primary practice location

2351 G Rd
Grand Junction, CO 81505-9641

Mailing address

PO Box 308
Montrose, CO 81402-0308
Phone (970) 497-8416

Other identifiers 1

IdentifierTypeStateIssuer
74609858MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050428000989 CO Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 4183521867 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Wisconsin School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Radiology Associates PCGroup PAC ID 7517959539, 5 clinicians

Practice addresses (Care Compare)

2351 G Rd
Grand Junction, CO 81505-9641
Phone (970) 644-3237

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0025745COMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lower Valley Hospital Association CurrentSince Aug 1, 2023 Accepting new patients
Lower Valley Hospital Association CurrentSince Aug 1, 2023 Accepting new patients
Diagnostic Radiology Associates PC Diagnostic Radiology CurrentSince Jun 1, 2005 Accepting new patients
Lower Valley Hospital Association Diagnostic Radiology Current Accepting new patients
Methodist Diagnostic Imaging Diagnostic Radiology Past Accepting new patients
Schryver Medical Sales and Marketing Inc. Past Accepting new patients
New Schryver LLC Past Accepting new patients
Lower Valley Hospital Association Past Accepting new patients

Locations

300 W Ottley Ave
Fruita, CO 81521
Phone (970) 858-3900

300 W Ottley Ave
#W
Fruita, CO 81521

2021 N 12th St
Grand Junction, CO 81501
Phone (970) 242-0920

2351 G Rd
Grand Junction, CO 81505
Phone (970) 242-0920

Organizations & group practices 8

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 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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1669474896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814020308",
            "telephone_number": "970-497-8416",
            "fax_number": "970-467-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 G RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815059641",
            "telephone_number": "970-644-3237",
            "fax_number": "970-644-3259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEGSTROM",
        "first_name": "TODD",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0025745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74609858",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.