Individual provider Active NPI

Hugh B Hedman, M.D.

  • Anesthesiology Physician
  • Niles, MI
National Provider Identifier
1962489765
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301506626 Issued in MI
Practice address
31 N Saint Joseph Ave
Niles, MI 49120-2207
Phone
(269) 687-1879
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301506626 MI Primary
Anesthesiology Physician 207L00000X 01044848 IN

Addresses

Primary practice location

31 N Saint Joseph Ave
Niles, MI 49120-2207

Mailing address

31 N Saint Joseph Ave
Niles, MI 49120-2207

Other practice location 1

416 E Monroe St
Suite 200
South Bend, IN 46601-2360
Phone (574) 232-8119

Other identifiers 1

IdentifierTypeStateIssuer
200084150MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230109001070 MI Practitioner - Anesthesiology 8325233174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Hospitals at Niles and St Joseph IncGroup PAC ID 7517929037, 134 clinicians

Practice addresses (Care Compare)

31 N Saint Joseph Ave
Niles, MI 49120-2207
Phone (269) 683-5510

Hospital & facility affiliations

  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01044848INMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Hospitals at Niles and St Joseph, Inc Anesthesiology CurrentSince Sep 28, 2022 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc Current Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Sep 28, 2022 Accepting new patients

Locations

31 N Saint Joseph Ave
Niles, MI 49120
Phone (269) 428-2417

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

Organizations & group practices 3

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 1

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1962489765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 N SAINT JOSEPH AVE",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 N SAINT JOSEPH AVE",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202207",
            "telephone_number": "269-687-1879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "416 E Monroe St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466012360",
            "country_code": "US",
            "telephone_number": "574-232-8119",
            "fax_number": "574-288-0235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEDMAN",
        "first_name": "HUGH",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301506626",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01044848",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200084150",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, MI

Sources for this page

Verify at the official NPI Registry.