Individual provider Active NPI

Jeffrey S Heden, O.D.

  • Optometrist
  • Rock Island, IL
National Provider Identifier
1770580797
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009502 Issued in IL
Practice address
4032 46TH Ave
Rock Island, IL 61201-7164
Phone
(309) 786-9734
Fax
(309) 786-9790
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009502 IL Primary

Addresses

Primary practice location

4032 46TH Ave
Rock Island, IL 61201-7164

Mailing address

8309 N Knoxville Ave
Peoria, IL 61615-2170
Phone (309) 693-9540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080211000716 IL Practitioner - Optometry 4486737657 Reassigns benefits to 1 organization
I20221102002337 IA Practitioner - Optometry 4486737657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Surgeons Associates PCGroup PAC ID 4183521206, 19 clinicians

Practice addresses (Care Compare)

422 S State St
Geneseo, IL 61254-1536
Phone (309) 944-8888

777 Tanglefoot LN
Bettendorf, IA 52722-1650
Phone (563) 323-2020

Merit-based Incentive Payment System (MIPS)

Final score
78.56 of 100Reported as group
Quality
97.61
Promoting interoperability
98
Improvement activities
40
Cost
32.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Surgeons Associates PC Optometrist CurrentSince Sep 1, 2022 Accepting new patients
Eye Surgeons Associates PC Optometrist PastSince Sep 1, 2022 Accepting new patients
Miller Eye Center LTD Past Accepting new patients
J a K Enterprises Inc Optometrist PastSince Nov 24, 2013 Accepting new patients
Miller Eye Center LTD Past Accepting new patients

Locations

777 Tanglefoot Ln
Bettendorf, IA 52722
Phone (319) 323-8888

422 S State St
Geneseo, IL 61254
Phone (309) 944-4608

2570 24th St
Ste 124
Rock Island, IL 61201
Phone (309) 779-3670

4731 45th Street Ct
Rock Island, IL 61201
Phone (309) 793-2020

Interoperability endpoints

  • Direct secure messaging: jeffrey.heden.p1@direct.esaeyecare.nextgenshare.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1770580797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152170",
            "telephone_number": "309-693-9540",
            "fax_number": "309-693-9754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4032 46TH AVE",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017164",
            "telephone_number": "309-786-9734",
            "fax_number": "309-786-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDEN",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

Verify at the official NPI Registry.