NPIMap

Individual provider Active NPI

Matthew J Hegewald, MD

  • Pulmonary Disease Physician
  • Bend, OR
National Provider Identifier
1710094065
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD19543 Issued in OR
Practice address
2275 NE Doctors Dr Ste 5
Bend, OR 97701-6324
Phone
(541) 706-7715
Fax
(541) 706-7742
NPI assigned
Aug 24, 2006
Last updated
Oct 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD19543 OR Primary

Addresses

Primary practice location

2275 NE Doctors Dr Ste 5
Bend, OR 97701-6324

Mailing address

PO Box 1420
Redmond, OR 97756-0400
Phone (541) 706-7715

Other identifiers 1

IdentifierTypeStateIssuer
075143MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address matthew.hegewald@direct.imail.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20070412000168 UT Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 5294639472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
University of Chicago, Pritzker School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

5121 S Cottonwood Dr
Imed Ekg Phys
Murray, UT 84157
Phone (801) 507-4660

5121 S Cottonwood St
Murray, UT 84107-5701
Phone (801) 507-4384

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19543ORMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince May 6, 2014 Accepting new patients
Ihc Health Services Inc CurrentSince May 6, 2014 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Ihc Health Services Inc CurrentSince Apr 1, 2025 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

8th Ave C St
Salt Lake City, UT 84143
Phone (801) 269-2500

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

5171 S Cottonwood St
South Salt Lake, UT 84107
Phone (801) 507-4000

Organizations & group practices 6

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1710094065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1420",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977560400",
            "telephone_number": "541-706-7715",
            "fax_number": "541-706-7742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 NE DOCTORS DR STE 5",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016324",
            "telephone_number": "541-706-7715",
            "fax_number": "541-706-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEGEWALD",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "MD19543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075143",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthew.hegewald@direct.imail.org",
            "affiliation": "N",
            "address_1": "5121 S Cottonwood St",
            "city": "Murray",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841075701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.