Jessica J Hegewald, OD

Individual provider Active NPI Optometrist · Silverthorne, CO

NPI 1740436732 · NPPES record last updated Mar 17, 2018

Key facts

NPI
1740436732
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
2671 (CO)
Practice address
358 Blue River Parkway
Suite D
Silverthorne, CO 80498
Phone
(303) 802-1022
Fax
(303) 802-1024
NPI assigned
Aug 11, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Optometry
Education
Pacific University - College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue River Vision PLLC (2 clinicians)

Practice addresses (Care Compare)

37 W 4TH St
E127
Silverthorne, CO 80498-9218
Phone (970) 451-0015

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20180410001114 CO Practitioner - Optometry 2062775802 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2671COMDOptometrist
636NMMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue River Vision PLLC Optometrist Current
since Mar 28, 2018
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 636 NM
Optometrist 152W00000X 2671 CO Yes

Addresses

Primary practice location

358 Blue River Parkway
Suite D
Silverthorne, CO 80498

Mailing address

PO Box 402
PMB 310
Dillion, CO 80435
Phone (970) 368-6539

Other practice location 1

15121 E Mississippi Ave
Attn: Dr. Jessica Hegewald
Aurora, CO 80012-3746
Phone (303) 802-1022

Other providers in Silverthorne, CO

All providers in Silverthorne, CO · Optometrist in Colorado

Sources for this page

Verify at the official NPI Registry.