DR. JOSHUA HEDAYA M.D.
NPI 1881618023
Ophthalmology in Thousand Oaks, CA
Quality Rating: 67.83 out of 100 score
NPI Status: Active since July 27, 2006
Contact Information
2230 LYNN RD STE 102
THOUSAND OAKS, CA
ZIP 91360
Phone: (805) 495-0458
Fax: (805) 494-9630
- NPI Profile Information
- Primary Taxonomy
- Secondary Taxonomies
- Insurance Plans Accepted
- Medicare Participation & PECOS Status
- Areas of Expertise
- Physician Visit Costs
- Overall Quality Performance
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Male
- Years of Experience 24
- Ophthalmology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About JOSHUA HEDAYA
This page provides the complete NPI Profile along with additional information for Joshua Hedaya, a provider established in Thousand Oaks, California with a medical specialization in Ophthalmology and more than 24 years of experience. He graduated from Chicago Homeopathic Medical College in 2002. The healthcare provider is registered in the NPI registry with number 1881618023 assigned on July 2006. The practitioner's primary taxonomy code is 207W00000X with license number A95681 (CA). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1881618023
- Provider Name
- DR. JOSHUA HEDAYA M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2230 LYNN RD STE 102 THOUSAND OAKS, CA 91360
- Location Phone
- (805) 495-0458
- Location Fax
- (805) 494-9630
- Mailing Address
- 3339 VIA VERDE CT CALABASAS, CA 91302
- Mailing Phone
- (818) 207-4795
- Medical School Name
- CHICAGO HOMEOPATHIC MEDICAL COLLEGE
- Graduation Year
- 2002
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-27-2006
- Last Update Date
- 07-12-2024
- Code Navigator
Ophthalmologists like Joshua Hedaya specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
Location Map
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
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- A95681
- License State
- CA
- Taxonomy Description
- An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
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) |
|---|---|---|---|---|
| 1 | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | MD459494 (PA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
- Blue Precision Bronze HMO? 205 - HMO
- Blue Max 70/50 $6700 - PPO
- Blue Max 90/70 $1500 - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $3300 - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 75/55 $1500 Standardized Plan - PPO
- Blue Saver 60/40 $6100 - PPO
- Blue Saver 90/70 $3200 - PPO
- Blue Focus Bronze POS? 205 - POS
- Blue Focus Bronze POS? 705 - POS
- Blue Focus Bronze POS? Standard - POS
- Blue Focus Gold POS? 207 - POS
- Blue Focus Gold POS? Standard - POS
- Blue Focus Silver POS? 206 - POS
- Blue Focus Silver POS? Standard - POS
- Blue Preferred Bronze PPO? 201 - PPO
- Blue Preferred Bronze PPO? 202 - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Advantage Bronze PPO? 202 - PPO
- Blue Advantage Bronze PPO? 203 - PPO
- Blue Advantage Bronze PPO? Standard - PPO
- Blue Advantage Gold PPO? 309 - PPO
- Blue Advantage Gold PPO? 604 - PPO
- Blue Advantage Gold PPO? Standard - PPO
- Blue Advantage Silver PPO? 204 - PPO
- Blue Advantage Silver PPO? 501 - PPO
- Blue Advantage Silver PPO? Standard - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- BlueSelect Bronze Basic - PPO
- BlueSelect Bronze Core - PPO
- BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
- BlueSelect Gold Core - PPO
- BlueSelect Gold HealthPlus - PPO
- BlueSelect Gold Standard without Kid's Dental - PPO
- BlueSelect Silver Classic - PPO
- BlueSelect Silver Classic without Kid's Dental - PPO
- BlueSelect Silver HealthPlus - PPO
- BlueSelect Silver HealthPlus without Kid's Dental - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*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 |
|---|---|---|---|
| 103225473 | MEDICAID (05) | PA |
Medicare Participation & PECOS Enrollment Status
Joshua Hedaya 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.
Joshua Hedaya 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: 5991705279
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: I20070110000592
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
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Compounded drug, not otherwise classified
Destruction of leaking blood vessels of retina using laser
Established patient complete exam of visual system
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 30-39 minutes
Exam of retinal blood vessels using a special camera after injection of a dye
Imaging of retina
Injection of drug into eye
Injection, aflibercept, 1 mg
Injection, faricimab-svoa, 0.1 mg
Injection, ranibizumab, 0.1 mg
New patient complete exam of visual system
Photography of the retina
Unclassified biologics
Unclassified drugs
A compounded drug is a personalized medication created to meet unique patient needs. If you can't take standard drugs due to allergies or need a specific dosage not commercially available, a pharmacist can mix ingredients to make a drug specifically for you.
This service was performed 17 times for 16 patientsThis procedure involves using a laser to treat leaking blood vessels in the retina, the part of the eye responsible for vision. The laser seals off these vessels, preventing further leakage and helping to preserve sight.
This service was performed 21 times for 14 patientsAn established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
This service was performed 1,892 times for 1,060 patientsThis is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 23 times for 23 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 14 times for 14 patientsThis procedure, known as a fluorescein angiography, involves taking images of the back of your eye. A dye is injected into your arm that travels to your eye, highlighting the blood vessels in your retina. This helps identify any abnormalities.
This service was performed 237 times for 232 patientsImaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
This service was performed 2,300 times for 904 patientsAn injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
This service was performed 1,655 times for 391 patientsAflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
This service was performed 2,682 times for 310 patientsFaricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
This service was performed 13,020 times for 102 patientsRanibizumab is a medication given via injection to treat certain eye conditions like age-related macular degeneration. It works by slowing vision loss and in some cases, improving vision by blocking abnormal blood vessel growth in the eye.
This service was performed 391 times for 21 patientsA new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
This service was performed 47 times for 47 patientsPhotography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
This service was performed 230 times for 224 patientsUnclassified biologics are a type of treatment derived from living organisms. They can include a wide range of substances, such as vaccines, blood components, or genes, used to prevent or treat diseases. Each is specifically designed to interact with the body's natural defenses to promote healing.
This service was performed 37 times for 30 patientsUnclassified drugs are medications that don't fit into an existing category or class due to their unique properties or uses. They may be used for various conditions and their effects may differ widely. Always ask your healthcare provider for more information about these drugs.
This service was performed 194 times for 84 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $35.18 for a new patient copayment and $19.27 for an established patient copayment.
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 91360 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $140.72
- Minimum New Patient Price $62.32
- Maximum New Patient Price $185.36
- Average New Patient Copayment $35.18
- Minimum New Patient Copayment $15.58
- Maximum New Patient Copayment $46.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $77.11
- Minimum Established Patient Price $20.68
- Maximum Established Patient Price $151.85
- Average Established Patient Copayment $19.27
- Minimum Established Patient Copayment $5.17
- Maximum Established Patient Copayment $37.96
* 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.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 67.83, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 67.83 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 66.14
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 89
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: 35.79
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: 35.79
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
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. Joshua Hedaya is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| WILKES-BARRE GENERAL HOSPITAL | 575 NORTH RIVER STREET WILKES-BARRE, PA 18764 | (570) 829-8111 | Acute 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. | |||||||||
| 1 | 8 | 8 | 1 | 6 | 1 | 8 | 0 | 2 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 16 | 1 | 12 | 1 | 16 | 0 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 1 + 6 + 1 + 1 + 2 + 1 + 1 + 6 + 0 + 4 + 24 = 57 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 57 = 3 | 3 | ||||||||
The NPI number 1881618023 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1245357565 | LYNN EYE MEDICAL GROUP Organization | Technician/Technologist (Ophthalmic) | 2230 LYNN RD STE 102 THOUSAND OAKS, CA 91360 (805) 495-0458 |
| 1730205337 | ROY T BUTERA M.D. Individual | Ophthalmology | 2230 LYNN RD STE 102 THOUSAND OAKS, CA 91360 (805) 495-0458 |
| 1447560388 | DR. PEGAH RAVEN OD Individual | Optometrist | 2230 LYNN RD STE 102 THOUSAND OAKS, CA 91360 (805) 495-0458 |
| 1316786643 | KRISTINE SHAHVERDYAN OD Individual | Optometrist | 2230 LYNN RD STE 102 THOUSAND OAKS, CA 91360 (805) 495-0458 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1881618023, enumerated in the NPI registry as an "individual" on July 27, 2006
The provider is located at 2230 Lynn Rd Ste 102 Thousand Oaks, Ca 91360 and the phone number is (805) 495-0458
The provider's speciality is Ophthalmology with taxonomy code 207W00000X
The provider has more than 24 years of experience. He graduated from Chicago Homeopathic Medical College in 2002.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois, Blue Cross. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 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.
The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information.
Medicare beneficiaries should expect a typical cost of $140.72 with an average copayment of $35.18 for new patient appointments. Established patients should expect a typical charge of $77.11 and an average copayment of 19.27. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Compounded drug, not otherwise classified, Destruction of leaking blood vessels of retina using laser, Established patient complete exam of visual system, Established patient office or other outpatient visit, 10-19 minutes, Established patient office or other outpatient visit, 30-39 minutes, Exam of retinal blood vessels using a special camera after injection of a dye, Imaging of retina, Injection of drug into eye, Injection, aflibercept, 1 mg, Injection, faricimab-svoa, 0.1 mg, Injection, ranibizumab, 0.1 mg, New patient complete exam of visual system, Photography of the retina, Unclassified biologics and Unclassified drugs.
The practitioner is affiliated to the following hospital(s): WILKES-BARRE GENERAL 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 July 27, 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].
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