Michael James Henehan, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A4724 Issued in CA

Practice address

455 Oconnor Dr
Ste 210
San Jose, CA 95128-1633

Phone

(408) 995-5453

Fax

(408) 275-9442

NPI assigned

Oct 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mhenehan41955@santaclaravalley.direct-ci.net

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.

• University Healthcare Alliance

  • Internal Medicine Physician
  • Newark, CA
  • NPI 1760531198
  Medicare reassignment NPD
• Affinity Medical Group

  • Case Manager/Care Coordinator
  • Foster City, CA
  • NPI 1689708042
  NPD (past)
• Family Medicine Associates of San Jose Inc

  • Family Medicine Physician
  • San Jose, CA
  • NPI 1932268109
  NPD (past)
• Family Practice Medical Associates, Inc.

  • Family Medicine Physician
  • San Jose, CA
  • NPI 1205880366
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1053497685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DR",
            "address_2": "STE 210",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281633",
            "telephone_number": "408-995-5453",
            "fax_number": "408-275-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DR",
            "address_2": "STE 210",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281633",
            "telephone_number": "408-995-5453",
            "fax_number": "408-275-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENEHAN",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A4724",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A4724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Therese Hendricks
• Rocio Angelica Hendrix, LMFT
• Ryan Hendrix, M.S., CCC-SLP
• Jane Hendry, PCD(DONA), IBCLC
• Martin James Henebury
• Krysten Henerfauth
• Vanesa Rose Heng
• Hengtong LLC
• Katherine Henkels, CNP
• Misty Autumn Henne-Bhullar, D.M.D.

• Family Medicine Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.