Individual provider Active NPI

Robert A Henning, PA

  • Medical Physician Assistant
  • Punta Gorda, FL
National Provider Identifier
1285736611
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9102276 Issued in FL
Practice address
25097 Olympia Ave
Punta Gorda, FL 33950-3903
Phone
(941) 764-5858
Fax
(941) 639-3805
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
No

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
Medical Physician Assistant 363AM0700X PA9102276 FL Primary

Addresses

Primary practice location

25097 Olympia Ave
Punta Gorda, FL 33950-3903

Mailing address

232 Hidden Bay Dr
#302
Osprey, FL 34229-9176
Phone (941) 966-3924

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040629001501 FL Practitioner - Physician Assistant 6901882851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1065 Tamiami TRL N
Nokomis, FL 34275-2144
Phone (941) 477-2364

13813 Metro Pkwy
Fort Myers, FL 33912-4343
Phone (239) 936-1343

150 W McKenzie St
Punta Gorda, FL 33950-5500
Phone (941) 621-6476

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

21298 Olean Blvd
Port Charlotte, FL 33952-6705
Phone (941) 629-1181

25097 Olympia Ave
Suite 102
Punta Gorda, FL 33950-3912
Phone (941) 237-7100

25098 Olympia Ave
Unit 400
Punta Gorda, FL 33950-3938
Phone (941) 621-6771

2675 Winkler Ave
Fort Myers, FL 33901-9328

2675 Winkler Avenue
Suite 200
Fort Myers, FL 33901-9328

3340 Tamiami TRL
Port Charlotte, FL 33952-8088
Phone (941) 237-7100

3571 Del Prado Blvd N
Suite 2
Cape Coral, FL 33909-5287
Phone (239) 656-6300

4130 Tamiami TRL
Suite 2
Port Charlotte, FL 33952-9207
Phone (941) 787-7100

900 Pine St
Suite 221
Englewood, FL 34223-4458
Phone (941) 548-1708

Hospital & facility affiliations

  • Adventhealth Port Charlotte Hospital, Port Charlotte, FL, CCN 100077
  • HCA Florida Fawcett Hospital Hospital, Port Charlotte, FL, CCN 100236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9102276FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Dec 6, 2021 Accepting new patients
Millennium Physician Group LLC CurrentSince Dec 6, 2021 Accepting new patients

Locations

3340 Tamiami Trl
Pt Charlotte, FL 33952
Phone (941) 764-5858

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

25097 Olympia Ave
Ste 102
Punta Gorda, FL 33950
Phone (941) 237-7100

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: robert.henning.1@4290.direct.athenahealth.com

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 2

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285736611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 HIDDEN BAY DR",
            "address_2": "#302",
            "city": "OSPREY",
            "state": "FL",
            "postal_code": "342299176",
            "telephone_number": "941-966-3924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25097 OLYMPIA AVE",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503903",
            "telephone_number": "941-764-5858",
            "fax_number": "941-639-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNING",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Punta Gorda, FL

Sources for this page

Verify at the official NPI Registry.