Individual provider Active NPI

Jennifer L Henderson, D.O.

  • Anesthesiology Physician
  • Pontiac, MI
National Provider Identifier
1013147701
Registry record updated Jul 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
5101018380 Issued in MI
Practice address
44555 Woodward Ave
Suite 308
Pontiac, MI 48341-5031
Phone
(248) 858-2509
NPI assigned
Jul 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 5101018380 MI Primary

Addresses

Primary practice location

44555 Woodward Ave
Suite 308
Pontiac, MI 48341-5031

Mailing address

44555 Woodward Ave
Suite 308
Pontiac, MI 48341-5031
Phone (248) 858-2509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131216000262 MI Practitioner - Anesthesiology 9931336153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Ann Arbor PLLCGroup PAC ID 1355317223, 213 clinicians

Practice addresses (Care Compare)

1560 E Maple Rd
Troy, MI 48083-1135
Phone (248) 817-2001

Hospital & facility affiliations

  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

Merit-based Incentive Payment System (MIPS)

Final score
67.5 of 100Reported as group
Quality
58.12
Improvement activities
40
Cost
68.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101018380MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Ann Arbor, PLLC Anesthesiology CurrentSince May 1, 2018 Accepting new patients
University Physician Group Past Accepting new patients

Locations

2006 Hogback Rd
Ste 5
Ann Arbor, MI 48105
Phone (313) 712-4331

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

1560 E Maple Rd
Troy, MI 48083
Phone (248) 581-5729

1560 E Maple Rd
#100
Troy, MI 48083
Phone (248) 817-2001

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373587200000",
    "number": "1013147701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44555 WOODWARD AVE",
            "address_2": "SUITE 308",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415031",
            "telephone_number": "248-858-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44555 WOODWARD AVE",
            "address_2": "SUITE 308",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415031",
            "telephone_number": "248-858-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2013-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "5101018380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.