JONATHAN ALLISTER HEFNER MD
NPI 1821037110
Hospitalist in Atlanta, GA

NPI Status: Active since June 05, 2006

Contact Information

1000 JOHNSON FERRY RD
ATLANTA, GA
ZIP 30342
Phone: (404) 851-8000
Fax: (404) 851-6325

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  • Individual
  • Male
  • Years of Experience 24
  • Hospitalist
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About JONATHAN HEFNER

Jonathan Hefner is a provider established in Atlanta, Georgia and his medical specialization is Hospitalist with more than 24 years of experience. He graduated from Michigan State University College Of Human Medicine in 2000. The healthcare provider is registered in the NPI registry with number 1821037110 assigned on June 2006. The practitioner's primary taxonomy code is 208M00000X with license number 058420 (GA). The provider is registered as an individual and his NPI record was last updated 6 years ago.

NPI
1821037110
Provider Name
JONATHAN ALLISTER HEFNER MD
Gender
Male
Entity Type
Individual
Location Address
1000 JOHNSON FERRY RD ATLANTA, GA 30342
Location Phone
(404) 851-8000
Location Fax
(404) 851-6325
Mailing Address
1000 JOHNSON FERRY RD ATLANTA, GA 30342
Mailing Phone
(404) 851-8000
Mailing Fax
(404) 851-6325
Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduation Year
2000
Is Sole Proprietor?
No
Enumeration Date
06-05-2006
Last Update Date
03-17-2018
Code Navigator

Jonathan Hefner is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The typical physician office visit costs for Medicare beneficiaries in this area are: $33.8 for a new patient copayment and $26.12 for an established patient copayment.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Hospitalist

Taxonomy Code
208M00000X
Type
Allopathic & Osteopathic Physicians
License No.
058420
License State
GA
Taxonomy Description
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

37924 (TN)
2208M00000XAllopathic & Osteopathic Physicians

Hospitalist

0037924 (TN)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Blue Cross and Blue Shield

    • Anthem Bronze Pathway Guided Access HMO 0% for HSA - HMO
    • Anthem Bronze Pathway Guided Access HMO 5000($0 Virtual PCP+$0 Select Drugs) - HMO
    • Anthem Bronze Pathway Guided Access HMO 6000($0 Virtual PCP+$0 Select Drugs) - HMO
    • Anthem Bronze Pathway Guided Access HMO 7500/50% Standard - HMO
    • Anthem Bronze Pathway Guided Access HMO 8000($0 Virtual PCP+$0 Select Drugs) - HMO
  • CareSource

    • CareSource Marketplace Bronze First - HMO
    • CareSource Marketplace Bronze First Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Core Gold - HMO
    • CareSource Marketplace Core Gold Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Diabetes Gold - HMO
  • Cigna Healthcare

    • Connect Bronze 3500 Indiv Med Deductible Enhanced Diabetes Care - EPO
    • Connect Bronze 5500 Indiv Med Deductible - EPO
    • Connect Bronze 6500 Indiv Med Deductible - EPO
    • Connect Bronze 8500 Indiv Med Deductible - EPO
    • Connect Bronze CMS Standard - EPO
  • Oscar Health Plan of Georgia

    • Bronze Classic 4700 - HMO
    • Bronze Classic PCP Saver Plus - HMO
    • Bronze Classic Standard - HMO
    • Bronze Elite + PCP Saver Plus - HMO
    • Bronze Simple 2 - HMO
  • Oscar Health Plan, Inc.

    • Bronze Classic (Choice) - HMO
    • Bronze Classic 4700 (Choice) - HMO
    • Bronze Classic 4700 (Select) - HMO
    • Bronze Classic PCP Saver Plus Rx Copay (Choice) - HMO
    • Bronze Classic PCP Saver Plus Rx Copay (Select) - HMO
  • Oscar Insurance Company

    • Bronze Classic - EPO
    • Bronze Classic | MercyOne - EPO
    • Bronze Classic 4700 - EPO
    • Bronze Classic 4700 | MercyOne - EPO
    • Bronze Classic PCP Saver Plus - EPO
  • Medicare

  • Medicaid

  • Blue Cross Blue Shield

  • Amerigroup

  • Wellcare

  • Cigna

  • Aetna

  • Railroad Medicare


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
2318844OTHER (01)GAUHC
4119104OTHER (01)TNBLUE CROSS BLUE SHIELD
52205825 001OTHER (01)GABCBS
10075404OTHER (01)GAAMERIGROUP
244807OTHER (01)GAWELLCARE
1168583OTHER (01)GACIGNA
372473269AMEDICAID (05)GA 
372473269CMEDICAID (05)GA 
372473269DMEDICAID (05)GA 
3889851MEDICAID (05)TN 
7133613OTHER (01)GAAETNA
P00408939OTHER (01)GAMEDICARE RAILROAD

PECOS Enrollment and Medicare Participation Status

Jonathan Hefner is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 7719946664

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20070206000410

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • Other DME (D1E)

    Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) (HCPCS:E0466)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

  • Oxygen and supplies (D1C)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    3 DME suppliers used 16 Medicare Claims 16 Services Paid

  • Oxygen and supplies (D1C)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    1 DME suppliers used 11 Medicare Claims 11 Services Paid

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 30342 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $135.21
  • Minimum New Patient Price $58.88
  • Maximum New Patient Price $178.51
  • Average New Patient Copayment $33.8
  • Minimum New Patient Copayment $14.72
  • Maximum New Patient Copayment $44.62

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $104.48
  • Minimum Established Patient Price $18.36
  • Maximum Established Patient Price $145.86
  • Average Established Patient Copayment $26.12
  • Minimum Established Patient Copayment $4.59
  • Maximum Established Patient Copayment $36.46

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jonathan Hefner is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
NORTHSIDE HOSPITAL1000 JOHNSON FERRY ROAD, NE
ATLANTA, GA 30342
(404) 851-8000Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1821037110
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2841031412
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 4 + 1 + 0 + 3 + 1 + 4 + 1 + 2 + 24 = 50
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1821037110 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1558357269 CAROL W BROOKS CRNA
Individual
Nurse Anesthetist, Certified Registered1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1740276476 CYNTHIA N DAVIS CRNA
Individual
Nurse Anesthetist, Certified Registered1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1114913852 BRENDA A BUCKNER NP
Individual
Nurse Practitioner (Adult Health)1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1487640124 LYNN M FEEMAN NP
Individual
Nurse Practitioner (Family)1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1043206139 STEPHEN C GRICE MD
Individual
Anesthesiology1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1184610297 HOWARD Y HONG MD
Individual
Anesthesiology1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1609862739 ROBERT P S INTRONA MD
Individual
Anesthesiology1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1558794875MRS. ANGELA MICHELLE MARQUIS AA-C
Individual
Anesthesiologist Assistant1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1841626330 RASAKI ADEBISI PAAA
Individual
Anesthesiologist Assistant1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1003242504 SHELLEY S STATON PAAA
Individual
Anesthesiologist Assistant1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1639505134 CHRISTY A HARRY PAAA
Individual
Anesthesiologist Assistant1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1821424318 ROBERT C COSTE PAAA
Individual
Anesthesiologist Assistant1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1720414741 SANDRA O HRDLICKA PAAA
Individual
Anesthesiologist Assistant1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1437257938DR. TAMEEKA L LAW MD
Individual
Obstetrics & Gynecology (Maternal & Fetal Medicine)1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(404) 851-8988
1437563061 KEUN YIM CRNA
Individual
Nurse Anesthetist, Certified Registered1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1568876167 CHRIS DEJELO
Individual
Anesthesiologist Assistant1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1306253653 CHRISTOPHER WADE
Individual
Anesthesiologist Assistant1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1962810515 ELIZABETH TUCKER
Individual
Nurse Anesthetist, Certified Registered1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1255732780 WESLEY HALL PAAA
Individual
Anesthesiologist Assistant1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181
1699177808 PHAT LUONG PAAA
Individual
Anesthesiologist Assistant1000 JOHNSON FERRY RD
ATLANTA, GA 30342
(770) 645-9181

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1821037110, enumerated in the NPI registry as an "individual" on June 05, 2006

The provider is located at 1000 Johnson Ferry Rd Atlanta, Ga 30342 and the phone number is (404) 851-8000

The provider's speciality is Hospitalist with taxonomy code 208M00000X

The provider has more than 24 years of experience. He graduated from Michigan State University College Of Human Medicine in 2000.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 14, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $135.21 with an average copayment of $33.8 for new patient appointments. Established patients should expect a typical charge of $104.48 and an average copayment of 26.12. Please review your insurance plan or contact the provider directly to determine your specific costs.

The practitioner is affiliated to the following hospital(s): NORTHSIDE HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on June 05, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.