Robert Emmett Henry III, M.D., M.S.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

GO74794 Issued in CA

Practice address

558 Saint Charles Dr
Suite 200
Thousand Oaks, CA 91360-3903

Phone

(805) 379-2322

Fax

(805) 379-2373

NPI assigned

Mar 15, 2007

Last updated

Oct 26, 2015By 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 identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

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

Physical Medicine and Rehabilitation

Education

University of California, Geffen School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Body Dynamix Integrated Sports Medicine IncGroup PAC ID 4688003221, 2 clinicians

Domenick J Sisto M D IncGroup PAC ID 0648230292, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.93 of 100Reported as group

Quality

83.47

Improvement activities

40

Cost

61.8

Merit-based Incentive Payment System (MIPS)

Final score

70.45 of 100Reported as group

Quality

30

Promoting interoperability

100

Improvement activities

40

Cost

47.63

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GJEEDD
• Direct secure messaging: rhenry@laoi1795.srs-direct.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.

• Body Dynamix Integrated Sports Medicine, Inc

  • Physical Medicine & Rehabilitation Physician
  • Tarzana, CA
  • NPI 1912386376
  Medicare reassignment Care Compare group NPD
• Domenick J Sisto M D Inc

  dba Los Angeles Orthopaedic Institute

  • Specialist
  • Palmdale, CA
  • NPI 1710941539
  Medicare reassignment Care Compare group NPD
• Orthopedic Medical Center2

  • Orthopaedic Surgery Physician
  • Reseda, CA
  • NPI 1952624595
  Medicare reassignment NPD
• Shariar Cohen MD Corp

  • Rheumatology Physician
  • Thousand Oaks, CA
  • NPI 1831331073
  Medicare reassignment NPD
• Erik C. Spayde, M.D., Inc.

  dba Erik C. Spayde, M.D.

  • Orthopaedic Surgery Physician
  • Thousand Oaks, CA
  • NPI 1790717965
  Medicare reassignment
• Cottage Medical Foundation

  dba Cottage Medical Group

  • Clinic/Center
  • Santa Barbara, CA
  • NPI 1770352130
  NPD
• Body Dynamix Chiropractic and Performance

  • Chiropractor
  • Encino, CA
  • NPI 1619145331
  NPD (past)
• Dignity Health

  dba St. John's Regional Medical Center

  • General Acute Care Hospital
  • Oxnard, CA
  • NPI 1073665360
  NPD (past)
• Goleta Valley Cottage Hospital

  • Skilled Nursing Facility
  • Goleta, CA
  • NPI 1679587224
  NPD (past)
• Los Robles Regional Medical Center

  dba Los Robles Hospital & Medical Center

  • General Acute Care Hospital
  • Thousand Oaks, CA
  • NPI 1033163019
  NPD (past)
• Mahyar Okhovat, M.D. Inc

  • Neurology Physician
  • Agoural Hills, CA
  • NPI 1922484054
  NPD (past)
• Shariar Cohen MD Corp

  • Rheumatology Physician
  • Thousand Oaks, CA
  • NPI 1841804572
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1306970900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100-7 RANCH ROAD",
            "address_2": "348",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913626017",
            "telephone_number": "805-497-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 SAINT CHARLES DR",
            "address_2": "SUITE 200",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913603903",
            "telephone_number": "805-379-2322",
            "fax_number": "805-379-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "ROBERT",
        "middle_name": "EMMETT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "CA",
            "license": "GO74794",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "GO74794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "CC801Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADDITIONAL PTAN",
            "identifier": "CC801Y",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WG74794E",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Edward Y Henjyoji, MD
• Susan E Henson, MS, BCBA
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• Cruz Patricia Hernandez

• Physical Medicine & Rehabilitation Physician in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; 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.