Active NPI
Jacquelyn A. Hedlund, MD
- Hematology (Internal Medicine) Physician
- Scarborough, ME
National Provider Identifier
1699746453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology (Internal Medicine) Physician
- License
- 13509
- Practice address
- 100 Campus Drive
Suite 108
Scarborough, ME 04074-9308 - Phone
- (207) 396-7600
- Fax
- (207) 396-7986
- NPI assigned
- Jan 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | 13509 | ME | |
| Hematology (Internal Medicine) Physician | 207RH0000X | 13509 | ME | Primary |
Addresses
Primary practice location
100 Campus Drive
Suite 108
Scarborough, ME 04074-9308
Mailing address
P.O. Box 911
Brattleboro, VT 05302
Phone (207) 396-7600
Other practice location 1
51 US Route 1 Ste I
Scarborough, ME 04074-7145
Phone (207) 303-3300
Other practice location 2
105 Topsham Fair Mall Rd Unit 1
Topsham, ME 04086-1773
Phone (207) 729-1148
Other practice location 3
2 Independence Dr
Kennebunk, ME 04043-6078
Phone (207) 985-0008
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5656679 | Other | ME | AETNA |
| 6628849 | Other | ME | CIGNA |
| 2017782 | Other | ME | AETNA HMO |
| 030520 | Other | ME | ANTHEM BCBS |
| 288720099 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13509 | ME | MD | Hematology (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Healthcare Partners, PA | Past | Accepting new patients | |
| Mainehealth | Past | Accepting new patients |
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 and National Provider Directory roles.
-
dba MaineHealth Pharmacy Brighton Ave
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
dba Spectrum Radiology South
- Diagnostic Radiology Physician
- Portland, ME
- NPI 1669488011
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538524800000",
"number": "1699746453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 911",
"city": "BRATTLEBORO",
"state": "VT",
"postal_code": "05302",
"telephone_number": "207-396-7600",
"fax_number": "207-396-7986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CAMPUS DRIVE",
"address_2": "SUITE 108",
"city": "SCARBOROUGH",
"state": "ME",
"postal_code": "040749308",
"telephone_number": "207-396-7600",
"fax_number": "207-396-7986"
}
],
"practiceLocations": [
{
"address_1": "51 US Route 1 Ste I",
"address_purpose": "LOCATION",
"city": "Scarborough",
"state": "ME",
"postal_code": "040747145",
"country_code": "US",
"telephone_number": "207-303-3300",
"fax_number": "207-303-3016",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "105 Topsham Fair Mall Rd Unit 1",
"address_purpose": "LOCATION",
"city": "Topsham",
"state": "ME",
"postal_code": "040861773",
"country_code": "US",
"telephone_number": "207-729-1148",
"fax_number": "207-729-2789",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2 Independence Dr",
"address_purpose": "LOCATION",
"city": "Kennebunk",
"state": "ME",
"postal_code": "040436078",
"country_code": "US",
"telephone_number": "207-985-0008",
"fax_number": "207-985-9820",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HEDLUND",
"first_name": "JACQUELYN",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-30",
"last_updated": "2018-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "ME",
"license": "13509",
"primary": false
},
{
"code": "207RH0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology",
"state": "ME",
"license": "13509",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5656679",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6628849",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "2017782",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "030520",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "288720099",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scarborough, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.