Individual provider Active NPI

Fraser Henderson

  • Neurological Surgery Physician
  • Upper Marlboro, MD
National Provider Identifier
1063404788
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
20803 Issued in DC
Practice address
1401 Mercantile LN Ste 341
Upper Marlboro, MD 20774-4331
Phone
(301) 557-9049
Fax
(301) 654-9394
NPI assigned
Aug 18, 2005
Last updated
Sep 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 20803 DC Primary

Addresses

Primary practice location

1401 Mercantile LN Ste 341
Upper Marlboro, MD 20774-4331

Mailing address

1401 Mercantile LN
Upper Marlboro, MD 20774-4301
Phone (301) 557-9049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20090414000050 DC Practitioner - Neurosurgery 2860549623 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20803DCMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Neurosurgery Group Associates, LLC Neurological Surgery CurrentSince Sep 21, 2013 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1401 Mercantile Ln
Ste 341
Upper Marlboro, MD 20774

Interoperability endpoints

  • Direct secure messaging: fhenderson801577@direct.umm.edu

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1063404788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207744301",
            "telephone_number": "301-557-9049",
            "fax_number": "301-654-9394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN STE 341",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207744331",
            "telephone_number": "301-557-9049",
            "fax_number": "301-654-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "FRASER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "DC",
            "license": "20803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

Verify at the official NPI Registry.