JEFFREY ALAN DEDELOW M.D. NPI 1376758524

NPI Information

  • NPI: 1376758524
  • Provider Name: JEFFREY ALAN DEDELOW, M.D.
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 514 W 2ND ST
    BLOOMINGTON, IN
    ZIP 47403
  • Phone: (812) 353-3719

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NPI Details

Jeffrey Alan Dedelow, M.D. is a diagnostic radiology radiology in Bloomington, IN. 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.

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 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.

  • Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)
  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Initial hospital inpatient care per day, typically 70 minutes (HCPCS:99223)
  • Follow-up hospital inpatient care per day, typically 15 minutes (HCPCS:99231)
  • Initial hospital inpatient care per day, typically 50 minutes (HCPCS:99222)

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other 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: 11/21/2025

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