NPIMap

Individual provider Active NPI

John Joseph Hiestand, M.D.

  • Internal Medicine Physician
  • Fremont, OH
National Provider Identifier
1821085952
Registry record updated Oct 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-061218 Issued in OH
Practice address
2575 Hayes Ave
Suite 1
Fremont, OH 43420-5201
Phone
(419) 332-1551
Fax
(419) 332-1132
NPI assigned
Oct 4, 2005
Last updated
Oct 29, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-061218 OH Primary
Pediatrics Physician 208000000X 35-061218 OH

Addresses

Primary practice location

2575 Hayes Ave
Suite 1
Fremont, OH 43420-5201

Mailing address

2239 Augusta Dr
Fremont, OH 43420-9130
Phone (419) 355-8208

Other identifiers 6

IdentifierTypeStateIssuer
0828699MedicaidOH
0828699OtherOHBCMH
110049825OtherOHRAILROAD RETIREES
36D067581OtherOHCLIA
000000028816OtherOHANTHEM
4269829OtherOHAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100107000119 OH Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3375684731 Reassigns benefits to 1 organization
Practice locations: Fremont, OH

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Ohio State University College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Professional Services LTDGroup PAC ID 1456531870, 40 clinicians

Practice addresses (Care Compare)

715 S Taft Ave
Fremont, OH 43420-3237
Phone (419) 333-6462

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-061218OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
Memorial Hospital Past Accepting new patients
600 North Brush Opco LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jhiestand25221@direct.promedica.org

Organizations & group practices 4

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 10

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256774400000",
    "number": "1821085952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 AUGUSTA DR",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434209130",
            "telephone_number": "419-355-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 HAYES AVE",
            "address_2": "SUITE 1",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434205201",
            "telephone_number": "419-332-1551",
            "fax_number": "419-332-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIESTAND",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2009-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-061218",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-061218",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0828699",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMH",
            "identifier": "0828699",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD RETIREES",
            "identifier": "110049825",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "36D067581",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000028816",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4269829",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, OH

Sources for this page

Verify at the official NPI Registry.