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JEFFREY ALAN DEDELOW M.D. NPI 1376758524


NPI Information

NPI: 1376758524
Provider Name: JEFFREY ALAN DEDELOW, M.D.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

Organization: INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS INC

PECOS Registration: Yes

Address:
514 W 2ND ST
BLOOMINGTON, IN
ZIP 47403
Phone: (812) 353-3719
Get Directions

Jeffrey Alan Dedelow, M.D. is a diagnostic radiology radiology in Bloomington, IN with 22 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Jeffrey Alan Dedelow, M.D. NPI is 1376758524. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2002

The provider's business location address is:

514 W 2ND ST
BLOOMINGTON, IN
ZIP 47403-316
Phone: (812) 353-3719

The NPI 1376758524 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • X-ray of chest, 1 view, front (HCPCS:71010)
  • X-ray of chest, 2 views, front and side (HCPCS:71020)

The enumeration date for this NPI number is 5/11/2007 and was last updated on 12/9/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0002XInternal MedicineHospice and Palliative Medicine01069197AINDIANANo
22085N0904XRadiologyNuclear Radiology4301089258MICHIGANNo
32085R0202XRadiologyDiagnostic RadiologyMD026741LOUISIANANo
42085R0202XRadiologyDiagnostic Radiology4301089258MICHIGANNo
52085R0202XRadiologyDiagnostic Radiology35.122017OHIONo
62085R0202XRadiologyDiagnostic Radiology01069197AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
104377066MEDICAIDMISSISSIPPI
2201015030MEDICAIDINDIANA
3P01119545OTHERINDIANARAILROAD MEDICARE
41049913MEDICAIDLOUISIANA
55186380MEDICAIDMICHIGAN
60090190MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.