Martha J Henderson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

214056-1 Issued in NY

Practice address

365 3Rd Ave
4C
New York, NY 10016-9074

Phone

(646) 320-2467

Fax

(917) 261-7882

NPI assigned

Apr 11, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• New York Downtown Medical Associates

  • Internal Medicine Physician
  • New York, NY
  • NPI 1427095652
  NPD (past)
• Ny Downtown Faculty Practice Opd

  • Family Medicine Physician
  • New York, NY
  • NPI 1396780581
  NPD (past)
• St Vincents Hospital and Medical Center

  • Specialist
  • New York, NY
  • NPI 1285746354
  NPD (past)

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1033172705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 3RD AVE",
            "address_2": "4C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169074",
            "telephone_number": "646-320-2467",
            "fax_number": "917-261-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 3RD AVE",
            "address_2": "4C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169074",
            "telephone_number": "646-320-2467",
            "fax_number": "917-261-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MARTHA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "214056-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02439141",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karlyn Henderson, RN
• Katherine O'Neal Henderson, L.AC
• Korey Andrew Henderson, MD
• Lacey Delaine Henderson, LCSW
• Lauren Henderson, MD
• Maryanne Henderson, NP
• Mica Henderson, LMSW
• Morgan Marie Henderson, RN, BSN
• Patricia Henderson
• Peter William Henderson, MD

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.