Mark C Henderson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C50464 Issued in CA

Practice address

4860 Y St Ste 100
Sacramento, CA 95817-2307

Phone

(916) 734-2737

NPI assigned

Mar 20, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Internal Medicine

Education

University of California, San Francisco School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Regents of the Univ of Ca

  • Maternal & Fetal Medicine Physician
  • Sacramento, CA
  • NPI 1013906973
  Medicare reassignment Care Compare group NPD
• Medaid Center

  • Internal Medicine Physician
  • La Jolla, CA
  • NPI 1508091307
  NPD (past) Authorized official
• Regents of the Univ of Ca

  • Cardiovascular Disease Physician
  • Sacramento, CA
  • NPI 1053304113
  NPD
• Regents of the Univ of Ca

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1477546406
  NPD
• Regents of the Univ of Ca

  • Surgery Physician
  • Sacramento, CA
  • NPI 1427041698
  NPD (past)
• Regents of the Univ of Ca

  • Pulmonary Disease Physician
  • Sacramento, CA
  • NPI 1437142692
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Regents of the University of California

  dba University of California Davis Medical Center

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1710918545
  Care Compare affiliation

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1184895856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 V ST STE 3100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 Y ST STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307",
            "telephone_number": "916-734-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MARK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-20",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C50464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00C504640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karmyla Venora Darlene Henderson
• Lauren Henderson
• Lonnisha Marshay Henderson
• Malia Henderson, NONE
• Marilet Henderson
• Mashay Marie Henderson I
• Matthew Henderson
• Molene Henderson
• Natasha Henderson
• Nicholas Joseph Henderson

• Internal Medicine Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; 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.

Verify at the official NPI Registry.