Active NPI
Karl Eric Henrikson, MD
- Diagnostic Radiology Physician
- Melrose, MA
National Provider Identifier
1063456309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 045803
- Practice address
- 585 Lebanon St
Radiology Department
Melrose, MA 02176-3225 - Phone
- (781) 979-3120
- Fax
- (781) 979-3994
- NPI assigned
- Jun 16, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 045803 | MA | Primary |
Addresses
Primary practice location
585 Lebanon St
Radiology Department
Melrose, MA 02176-3225
Mailing address
85 Ferdinand St
Melrose, MA 02176-1154
Phone (781) 979-3120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3008231 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045803 | MA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339027200000",
"number": "1063456309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 FERDINAND ST",
"city": "MELROSE",
"state": "MA",
"postal_code": "021761154",
"telephone_number": "781-979-3120",
"fax_number": "781-979-3994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "585 LEBANON ST",
"address_2": "RADIOLOGY DEPARTMENT",
"city": "MELROSE",
"state": "MA",
"postal_code": "021763225",
"telephone_number": "781-979-3120",
"fax_number": "781-979-3994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRIKSON",
"first_name": "KARL",
"middle_name": "ERIC",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-16",
"last_updated": "2012-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "045803",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3008231",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melrose, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.