Individual provider Active NPI

Andrew Dave Henry, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Tampa, FL
National Provider Identifier
1194892141
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
79549 Issued in FL
Practice address
9260 Bay Plaza Blvd
Suite 502
Tampa, FL 33619-4458
Phone
(813) 676-0234
Fax
(813) 676-0237
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 79549 FL Primary

Addresses

Primary practice location

9260 Bay Plaza Blvd
Suite 502
Tampa, FL 33619-4458

Mailing address

9260 Bay Plaza Boulevard
Suite 502
Tampa, FL 33619
Phone (813) 676-0234

Other identifiers 1

IdentifierTypeStateIssuer
2581760DMedicaidFL

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
I20120321000696 FL Practitioner - Endocrinology 6406049287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
State University of New York at Buffalo School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9260 Bay Plaza Blvd
Suite 502
Tampa, FL 33619-4458
Phone (813) 676-0234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79549FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew D. Henry M.D., P.a. CurrentSince Jan 30, 2012 Accepting new patients
Summerfield Medical Clinic MD PA Endocrinology, Diabetes & Metabolism PastSince Jun 2, 2010 Accepting new patients

Locations

9270 Bay Plaza Blvd
Ste 620
Tampa, FL 33619
Phone (813) 251-6911

9260 Bay Plaza Blvd
Ste 502
Tampa, FL 33619
Phone (813) 676-0234

9270 Bay Plaza Blvd
Ste 640
Tampa, FL 33619
Phone (813) 621-0130

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGDDCA/Endpoint/JGDDCA

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1194892141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9260 BAY PLAZA BOULEVARD",
            "address_2": "SUITE 502",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33619",
            "telephone_number": "813-676-0234",
            "fax_number": "813-676-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9260 BAY PLAZA BLVD",
            "address_2": "SUITE 502",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194458",
            "telephone_number": "813-676-0234",
            "fax_number": "813-676-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "ANDREW",
        "middle_name": "DAVE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "79549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2581760D",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.