Active NPI
Fraser Henderson
- Neurological Surgery Physician
- Upper Marlboro, MD
National Provider Identifier
1063404788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 20803
- 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, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20803 | DC | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metropolitan Neurosurgery Group Associates, LLC | Neurological Surgery | Current | 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
- 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.
-
- Neurological Surgery Physician
- Upper Marlboro, MD
- NPI 1477892545
-
- Durable Medical Equipment & Medical Supplies
- Upper Marlboro, MD
- NPI 1528205408
DC
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
dba Windber Medical Center
- General Acute Care Hospital
- Windber, PA
- NPI 1275620536
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
- Hebron Care Center Inc (Hebron Care Center)
- Help Is Here Services Unlimited, Inc
- Help Is Here Services Unlimited, Inc
- Helping Hands Behavioral Health Services, LLC
- Helping Hands, Inc. (In Home Care Aides)
- Reia Margaret Henley, LICSW
- Charnae Henry-Smith
- Shanice Henry
- Nija A Hepburn-Nelson, LGPC
- Sacorra Breanna Hepburn
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.