Michael Kyle Hendricks, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

309 Jackson St
Monroe, LA 71201-7407

Phone

(318) 966-2397

NPI assigned

May 17, 2012

Last updated

Jun 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kyle Hendricks Professional name

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Green Clinic LLCGroup PAC ID 4789668831, 29 clinicians

Radiology Associates LLCGroup PAC ID 8628041464, 83 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fmol Health St Francis Hospital, Monroe, LA, CCN 190125
• Northern Louisiana Medical Center Hospital, Ruston, LA, CCN 190086

Merit-based Incentive Payment System (MIPS)

Final score

94.47 of 100Reported as group

Improvement activities

40

Cost

73.21

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.hendricks.1@26990.direct.athenahealth.com

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.

• Green Clinic LLC

  • Family Medicine Physician
  • Ruston, LA
  • NPI 1831178755
  Medicare reassignment Care Compare group NPD
• Radiology Associates LLC

  • Diagnostic Radiology Physician
  • Baton Rouge, LA
  • NPI 1659347771
  Medicare reassignment Care Compare group NPD
• Monroe Emergency Physicians LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Monroe, LA
  • NPI 1386235331
  Medicare reassignment

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

• CLHG-Ruston LLC

  dba Northern Louisiana Medical Center

  • General Acute Care Hospital
  • Ruston, LA
  • NPI 1962024026
  Care Compare affiliation
• St Francis Medical Center, Inc

  • General Acute Care Hospital
  • Monroe, LA
  • NPI 1295723229
  Care Compare affiliation

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1205196805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 KNOLL CREEK CIR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712914773",
            "telephone_number": "318-366-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 JACKSON ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017407",
            "telephone_number": "318-966-2397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "804 Polk St",
            "address_purpose": "LOCATION",
            "city": "Winnsboro",
            "state": "LA",
            "postal_code": "712952350",
            "country_code": "US",
            "telephone_number": "318-435-1550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "MICHAEL",
        "middle_name": "KYLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-17",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "LA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLE",
            "last_name": "HENDRICKS",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Renita Henderson
• Robert S. Hendrick Jr., M.D.
• Cecilia Hendricks
• Jessica Hendricks, NP
• Linda Hendricks
• Sidney Winters Hendry
• Henna Patel, LLC
• Henna Patel, LLC
• Jean Hennessey
• Alyssa Paige Hennigan

• Physician Assistant in Monroe, LA
• Providers in Monroe, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.