NPIMap

Individual provider Active NPI

Michael Terrence Hegstrom, MD

  • Surgery Physician
  • Port Matilda, PA
National Provider Identifier
1952330128
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD444655 Issued in PA
Practice address
132 Abigail Lane
Port Matilda, PA 16870
Phone
(814) 272-5011
NPI assigned
Jul 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 21695 WV
Surgery Physician 208600000X MD444655 PA Primary

Addresses

Primary practice location

132 Abigail Lane
Port Matilda, PA 16870

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
3810001358MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mhegstrom97839@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20120123000484 PA Practitioner - General Surgery 7618922071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Alabama School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

132 Abigail LN
Port Matilda, PA 16870-7153
Phone (814) 272-7100

210 Medical Ctr Dr
Philipsburg, PA 16866-1948
Phone (814) 342-8020

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD444655PAMDSurgery Physician
21695WVMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jan 1, 2012 Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2012 Accepting new patients
Geisinger Clinic Current Accepting new patients
Anniston General Surgery Center, P.C. Surgery PastSince Oct 1, 2020 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

27 Sandy Ln
Lewistown, PA 17044
Phone (717) 242-0311

27 Sandy Ln
Ste 140
Lewistown, PA 17044
Phone (717) 242-2711

27 Sandy Ln
Ste 200
Lewistown, PA 17044
Phone (717) 242-2525

400 Highland Ave
Lewistown, PA 17044
Phone (717) 242-7473

210 Medical Center Dr
Philipsburg, PA 16866
Phone (814) 342-8001

132 Abigail Ln
Port Matilda, PA 16870
Phone (814) 272-5011

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

200 Scenery Dr
State College, PA 16801
Phone (814) 231-4560

611 University Dr
State College, PA 16801
Phone (814) 234-2600

Interoperability endpoints

  • Direct secure messaging: mhegstro@yourcarecommunity.org

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.

Hospital & facility affiliations 40

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1952330128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 ABIGAIL LANE",
            "city": "PORT MATILDA",
            "state": "PA",
            "postal_code": "16870",
            "telephone_number": "814-272-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEGSTROM",
        "first_name": "MICHAEL",
        "middle_name": "TERRENCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "21695",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD444655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001358",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhegstrom97839@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "132 Abigail Lane",
            "city": "Port Matilda",
            "state": "PA",
            "country_code": "US",
            "postal_code": "16870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port Matilda, PA

Sources for this page

Verify at the official NPI Registry.