Active NPI
Edward Cale Hendricks, M.D.
- Anesthesiology Physician
- Gloucester, VA
National Provider Identifier
1104088863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 0101249184
- Practice address
- 7519 Hospital Dr
Gloucester, VA 23061-4178 - Phone
- (703) 295-9360
- NPI assigned
- Jun 25, 2008
- Last updated
- Mar 18, 2015
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 0101249184 | VA | Primary |
Addresses
Primary practice location
7519 Hospital Dr
Gloucester, VA 23061-4178
Mailing address
68 S Service Rd
Ste 350
Melville, NY 11747-2354
Phone (516) 945-3107
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104088863 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Georgetown University School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
909 Squalicum Way
Suite 102
Bellingham, WA 98225-2077
Phone (360) 647-3377
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101249184 | VA | MD | Anesthesiology Physician |
| 235932 | MA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellingham Anesthesia Associates, P.S. | Anesthesiology | Current | Accepting new patients |
Locations
909 Squalicum Way
Ste 102
Bellingham, WA 98225
Phone (360) 647-3377
Interoperability endpoints
- chendricks36287@skagit.direct-ci.com
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Bellingham, WA
- NPI 1609893460
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Peacehealth Peace Island Medical Center
- Critical Access Hospital
- Friday Harbor, WA
- NPI 1487917233
-
dba Skagit Valley Hospital
- General Acute Care Hospital
- Mount Vernon, WA
- NPI 1053357244
-
dba Cascade Valley Hospital
- General Acute Care Hospital
- Arlington, WA
- NPI 1073566246
-
dba Northwest Regional Laboratory
- Clinical Medical Laboratory
- Bellingham, WA
- NPI 1013137173
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426636800000",
"number": "1104088863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 S SERVICE RD",
"address_2": "STE 350",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117472354",
"telephone_number": "516-945-3107",
"fax_number": "516-945-3131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7519 HOSPITAL DR",
"city": "GLOUCESTER",
"state": "VA",
"postal_code": "230614178",
"telephone_number": "703-295-9360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKS",
"first_name": "EDWARD",
"middle_name": "CALE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-25",
"last_updated": "2015-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "VA",
"license": "0101249184",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1104088863",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gloucester, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.