ED JERALD HENDRICKS M.D.
NPI 1700220092
Internal Medicine - Obesity Medicine in Roseville, CA

Q: What is Ed Hendricks's NPI number?

The NPI number for Ed Hendricks is 1700220092. It was assigned to this individual provider in the NPPES registry on April 17, 2013.

Q: What is Ed Hendricks's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Obesity Medicine, with taxonomy code 207RB0002X.

Q: Is Ed Hendricks enrolled in Medicare?

No. Ed Hendricks has opted out of Medicare through June 18, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Ed Hendricks was last updated on April 17, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 17, 2013Opted out of Medicare · through Jun 18, 2027

2510 DOUGLAS BLVD, SUITE 200, ROSEVILLE, CA 95661(916) 773-1191(916) 773-0498 Get Directions Write a Review

NPPES record last updated: April 17, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Ed Jerald Hendricks M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ED JERALD HENDRICKS M.D. (NPI 1700220092) is an individual obesity medicine provider in Roseville, California, licensed in California (G22146) and active in the NPI registry since April 2013. He has opted out of Medicare through June 18, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1700220092

Entity TypeIndividualMale

Primary Taxonomy207RB0002X

Provider Legal NameED JERALD HENDRICKSCredential: M.D.

Location Address2510 DOUGLAS BLVD, SUITE 200Roseville, CA 95661-3300

Mailing Address2510 Douglas Blvd, Suite 200Roseville, CA 95661-3300 · (916) 773-1191 · Fax (916) 773-0498

Phone(916) 773-1191

Fax(916) 773-0498

Sole ProprietorYes

Enumeration DateApril 17, 2013

✔ NPI 1700220092 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Obesity MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RB0002X

License✔ Licensed in CA · G22146

Definition

An internal medicine physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity.

2510 DOUGLAS BLVD, Roseville, CA 95661

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ed Jerald Hendricks M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 18, 2013 through June 18, 2027.

Opt-Out Effective DateJune 18, 2013

Opt-Out In Effect ThroughJune 18, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SABEENA ACHARYA

Psychiatry & Neurology (Psychiatry)

2510 DOUGLAS BLVD, 300
ROSEVILLE, CA 95661

Placer County (916) 740-3721

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ed Hendricks's NPI number?

The NPI number for Ed Hendricks is 1700220092. It was assigned to this individual provider in the NPPES registry on April 17, 2013.

Where is Ed Hendricks located?

Ed Hendricks practices at 2510 Douglas Blvd Suite 200, Roseville, CA 95661. The listed phone number is (916) 773-1191.

What is Ed Hendricks's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Obesity Medicine, with taxonomy code 207RB0002X.

Is Ed Hendricks enrolled in Medicare?

No. Ed Hendricks has opted out of Medicare through June 18, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Ed Hendricks was last updated on April 17, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.