Individual provider Active NPI

Marilyn C Henderson, DPM

  • Podiatrist
  • Lancaster, PA
National Provider Identifier
1245201789
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC002642L Issued in PA
Practice address
882 Millersville Rd
Lancaster, PA 17603-6154
Phone
(717) 291-0391
Fax
(717) 291-0832
NPI assigned
Feb 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC002642L PA Primary

Addresses

Primary practice location

882 Millersville Rd
Lancaster, PA 17603-6154

Mailing address

882 Millersville Road
Lancaster, PA 17603
Phone (717) 291-0391

Other identifiers 1

IdentifierTypeStateIssuer
1681042MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100521000532 PA Practitioner - Podiatry 9537182365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henderson Podiatry, LLCGroup PAC ID 3971858184, 3 clinicians

Practice addresses (Care Compare)

882 Millersville Rd
Lancaster, PA 17603-6154
Phone (717) 291-0391

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions11
Removal of nail tissue1116
Removal or shaving of skin growth407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245201789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 MILLERSVILLE ROAD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "17603",
            "telephone_number": "717-291-0391",
            "fax_number": "717-291-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 MILLERSVILLE RD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176036154",
            "telephone_number": "717-291-0391",
            "fax_number": "717-291-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MARILYN",
        "middle_name": "C",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC002642L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1681042",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.