Individual provider Active NPI

Brody Lars Henkel, M.D.

  • Neurology Physician
  • Tampa, FL
National Provider Identifier
1164511168
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME109304 Issued in FL
Practice address
2816 W Virginia Ave
Tampa, FL 33607-6330
Phone
(813) 876-6321
Fax
(813) 870-0350
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 28964 SC
Neurology Physician 2084N0400X ME109304 FL Primary

Addresses

Primary practice location

2816 W Virginia Ave
Tampa, FL 33607-6330

Mailing address

2816 W Virginia Ave
Tampa, FL 33607-6330
Phone (813) 876-6321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110801000311 FL Practitioner - Neurology 0941479331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurological Specialties Neurology PAGroup PAC ID 6709936107, 3 clinicians

Practice addresses (Care Compare)

2816 W Virginia Ave
Tampa, FL 33607-6330
Phone (813) 876-6321

Merit-based Incentive Payment System (MIPS)

Final score
90.52 of 100Reported as group
Quality
81.04
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME109304FLMDNeurology Physician
28964SCMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurological Specialties Neurology PA Neurology CurrentSince Aug 1, 2011 Accepting new patients
Neurological Specialties Neurosurgery PA PastSince Aug 1, 2011 Accepting new patients

Locations

2816 W Virginia Ave
Tampa, FL 33607
Phone (813) 876-6321

Interoperability endpoints

  • Direct secure messaging: brodyhenkel@nsp.ssdirect.aprima.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1164511168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2816 W VIRGINIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076330",
            "telephone_number": "813-876-6321",
            "fax_number": "813-870-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 W VIRGINIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076330",
            "telephone_number": "813-876-6321",
            "fax_number": "813-870-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKEL",
        "first_name": "BRODY",
        "middle_name": "LARS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "28964",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME109304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.