Physician Compare National (NPI:1053721258)

HEALTHCARE PROVIDER: JASON CODY HEDGE M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1053721258
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1254648223
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200603001883
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HEDGE
	Individual professional last name
Provider First Name	JASON
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2014
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SALEM RADIOLOGY CONSULTANTS PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0446148498
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	27
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2925 RYAN DR SE
	Group Practice or individual's line 1 address
City	SALEM
	Group Practice or individual's city
State	OR
	Group Practice or individual's state
Zip Code	973019687
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5033991262
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	380051
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SALEM HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	381308
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	WEST VALLEY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y