Timothy Koplik Henderson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

125072398 Issued in IL

Practice address

4440 W 95TH St
Oak Lawn, IL 60453-2600

Phone

(708) 684-5375

NPI assigned

May 24, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, NV2 enrollments

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 2

Specialty

Emergency Medicine

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Nevada Medical Center Hospital, Sparks, NV, CCN 290032
• Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019

Merit-based Incentive Payment System (MIPS)

Final score

88.65 of 100Reported as group

Quality

86.65

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

93.85 of 100Reported as group

Quality

91.15

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Carson Tahoe Emergency Physicians

  • Emergency Medicine Physician
  • Carson City, NV
  • NPI 1396822821
  Medicare reassignment NPD
• Edwards Bell MD PC

  • Emergency Medicine Physician
  • Sparks, NV
  • NPI 1740157098
  Medicare reassignment
• Nevada Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Reno, NV
  • NPI 1730957275
  NPD
• Usacs Community Emergency Services of Colorado, Inc.

  • Emergency Medicine Physician
  • Arvada, CO
  • NPI 1053824979
  NPD
• Usacs of Colorado, Inc

  • Emergency Medicine Physician
  • Littleton, CO
  • NPI 1760415871
  NPD

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

• Carson Tahoe Regional Healthcare

  • General Acute Care Hospital
  • Carson City, NV
  • NPI 1255360160
  Care Compare affiliation
• Carson Tahoe Regional Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carson City, NV
  • NPI 1568281988

  Hospital

  Care Compare affiliation
• Sparks Family Hospital Inc

  • Emergency Care Clinic/Center
  • Reno, NV
  • NPI 1346934569

  Hospital

  Care Compare affiliation
• Sparks Family Hospital Inc

  • Emergency Care Clinic/Center
  • Reno, NV
  • NPI 1366232993

  Hospital

  Care Compare affiliation
• Sparks Family Hospital Inc

  • General Acute Care Hospital
  • Sparks, NV
  • NPI 1548250582
  Care Compare affiliation
• Sparks Family Hospital Inc

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1609451327
  Care Compare affiliation
• Sparks Family Hospital Inc

  • Emergency Care Clinic/Center
  • Reno, NV
  • NPI 1689229353

  Hospital

  Care Compare affiliation
• Sparks Family Hospital Inc

  • Emergency Care Clinic/Center
  • Sparks, NV
  • NPI 1952049132

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1033600168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-5375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "TIMOTHY",
        "middle_name": "KOPLIK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125072398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hesham K Hegazy, LPT
• Richard E Heller III, MD
• Gerald E Helwig, D.C.
• Afryea Henderson, MD
• Francesca Henderson
• Rachel N Hennigan, ED.S.
• Glenn C Henrikson, DO
• Heritage Medical Group LTD
• Camelia Hernandez
• Dahlia Hernandez

• Emergency Medicine Physician in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.