Active NPI
Patricia A Henderson, O.D.
- Optometrist
- Bloomington, IN
National Provider Identifier
1124097472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18002170
- Practice address
- 744 E Atwater Ave
Bloomington, IN 47401-3634 - Phone
- (812) 855-8436
- NPI assigned
- Mar 17, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Bloomington, IN
- NPI 1174566921
-
- General Practice Dentistry
- Indianapolis, IN
- NPI 1689790552
-
- Audiologist
- Bloomington, IN
- NPI 1982693743
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Indiana University
Practice addresses (Care Compare)
744 E 3Rd St
Bloomington, IN 47405-3603
Phone (812) 855-8436
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 11 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110210000278 | IN | Practitioner - Optometry | 3274510557 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana University | Optometrist | Current | Accepting new patients |
| Indiana University | Optometrist | Current | Accepting new patients |
| Indiana University | Current | Accepting new patients |
Locations
800 E Atwater Ave
Rm 263
Bloomington, IN 47405
744 E 3rd St
Bloomington, IN 47405
Phone (812) 855-8436
803 N Monroe St
#C
Bloomington, IN 47404
Phone (812) 855-1671
803 N Monroe St
Bloomington, IN 47404
Phone (812) 332-1262
Interoperability endpoints
- direct@indianaunivschoolofoptombloomingtonin.compulinkdirect.com
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18002170 | IN | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
744 E Atwater Ave
Bloomington, IN 47401-3634
Mailing address
744 E Atwater Ave
Bloomington, IN 47401-3634
Phone (812) 855-8436
Other identifiers 2
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100184400 | Medicaid | IN | |
| 2275916 | Medicaid | OH |
Electronic endpoints 1
NPPES NPI Registry| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Direct@IndianaUnivSchoolOfOptomBloomingtonIN.CompulinkDirect.com | Direct |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 12, 2026.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768176000000",
"number": "1124097472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "744 E ATWATER AVE",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474013634",
"telephone_number": "812-855-8436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "744 E ATWATER AVE",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474013634",
"telephone_number": "812-855-8436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "PATRICIA",
"middle_name": "A",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-17",
"last_updated": "2026-01-12",
"certification_date": "2026-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18002170",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100184400",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2275916",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Direct@IndianaUnivSchoolOfOptomBloomingtonIN.CompulinkDirect.com",
"affiliation": "N",
"endpointDescription": "IUSO direct email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "text",
"address_1": "744 E Atwater Ave",
"city": "Bloomington",
"state": "IN",
"country_code": "US",
"postal_code": "474013634",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.
- 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.