NPIMap

Individual provider Active NPI

Theresa Nilson Henke

  • Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1053636977
Registry record updated Mar 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A121297 Issued in CA
Practice address
8635 W 3Rd St Ste 1195W
Los Angeles, CA 90048-6146
Phone
(866) 423-8661
NPI assigned
Apr 3, 2010
Last updated
Mar 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD60668555 WA
Nephrology Physician 207RN0300X A121297 CA Primary

Addresses

Primary practice location

8635 W 3Rd St Ste 1195W
Los Angeles, CA 90048-6146

Mailing address

904 7TH Ave
Seattle, WA 98104-1132
Phone (206) 860-2308

Other practice location 1

904 7th Ave
Seattle, WA 98104-1132
Phone (206) 860-2308

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130813000959 CA Practitioner - NephrologyPractitioner - HospitalistPractitioner - Internal Medicine 0648412171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Hospitalist, Internal Medicine
Education
Boston University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

8635 W 3Rd St
Suite 465W
Los Angeles, CA 90048-6111
Phone (310) 423-0674

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60668555WAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince May 1, 2020 Accepting new patients
HCA Healthone LLC Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

8635 W 3rd St
Ste 1195W
Los Angeles, CA 90048
Phone (310) 423-8661

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

Interoperability endpoints

  • Direct secure messaging: tnilsonhenke228036@direct.cshs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1270252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1053636977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 7TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041132",
            "telephone_number": "206-860-2308",
            "fax_number": "206-860-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST STE 1195W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486146",
            "telephone_number": "866-423-8661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "904 7th Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981041132",
            "country_code": "US",
            "telephone_number": "206-860-2308",
            "fax_number": "206-860-2215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENKE",
        "first_name": "THERESA",
        "middle_name": "NILSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-03",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD60668555",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A121297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.