Raymond Henderson Sr., M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME59588 Issued in FL

Practice address

1411 N Flagler Dr
Suite 7300
West Palm Beach, FL 33401-3404

Phone

(561) 804-9898

Fax

(561) 804-9049

NPI assigned

Aug 21, 2006

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 11

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

Specialty

General Surgery

Education

Emory University School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palm Beach General Surgery LLCGroup PAC ID 1456455021, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Raulerson Hospital Hospital, Okeechobee, FL, CCN 100252

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 and National Provider Directory roles.

• Palm Beach General Surgery LLC

  • Surgery Physician
  • Loxahatchee, FL
  • NPI 1235326760
  Medicare reassignment Care Compare group
• Independent Multispecialty Group of Florida LLC

  • Surgery Physician
  • Wellington, FL
  • NPI 1346745122
  Medicare reassignment NPD
• Genesiscare USA of Florida LLC

  dba Venice Urology

  • Urology Physician
  • Venice, FL
  • NPI 1316127152
  NPD (past)
• The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Philadelphia, PA
  • NPI 1902959653
  NPD (past)

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

• Okeechobee Hospital, Inc.

  dba HCA Florida Raulerson Hospital

  • General Acute Care Hospital
  • Okeechobee, FL
  • NPI 1215974134
  Care Compare affiliation

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1275648750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "address_2": "ATTN: PAYER CONTRACTING & RELATIONS DEPT.",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR",
            "address_2": "SUITE 7300",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013404",
            "telephone_number": "561-804-9898",
            "fax_number": "561-804-9049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "RAYMOND",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME59588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM",
            "identifier": "P1024914",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4510159",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "221891",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055398100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREPLUS",
            "identifier": "1022165",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1605100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01591843",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM",
            "identifier": "P963010",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "03303",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "12883",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIMENSION",
            "identifier": "2886",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Helping Little Gigants, Inc
• Camile Desire Helton, CST-FA
• Helen Hembree, PA
• Cherreba Henderson
• Lashante P Henderson
• Shirley Johnson Henderson, L.M.H.C.
• Vivien Marie Henderson, LMT
• Aline Hendricksen-Moise
• Sherri Henley
• Michael P Hennessy, DDS

• Surgery Physician in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.