NPIMap

Individual provider Active NPI

Ronald Cameron Henzman, MD

  • Vascular & Interventional Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1356735484
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MT224142 Issued in PA
Practice address
3400 Spruce St
Philadelphia, PA 19104-4238
Phone
(215) 316-5151
NPI assigned
Mar 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Vascular & Interventional Radiology Physician 2085R0204X MT224142 PA Primary

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104-4238

Mailing address

3400 Spruce St
Philadelphia, PA 19104-4238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220518002490 KY Practitioner - Interventional Radiology 9931415338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
University of Louisville School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

216 W Walnut St
Suite a
Danville, KY 40422-1832
Phone (859) 239-5870

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.36 of 100Reported as group
Quality
64.78
Promoting interoperability
100
Improvement activities
40
Cost
67.25

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT224142PAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ephraim McDowell Health Resource, Inc CurrentSince May 5, 2022 Accepting new patients
The James B. Haggin Memorial Hospital Inc Current Accepting new patients
Ephraim McDowell Health Resource, Inc Vascular & Interventional Radiology CurrentSince May 5, 2022 Accepting new patients
The James B. Haggin Memorial Hospital Inc CurrentSince Jun 18, 2024 Accepting new patients
Nick Dedman, MD and Associates, P.S.C. Current Accepting new patients
Ephraim McDowell Health Resource, Inc. Current Accepting new patients
The James B. Haggin Memorial Hospital Inc CurrentSince Jun 18, 2024 Accepting new patients

Locations

109 Daniel Dr
Danville, KY 40422
Phone (859) 236-3361

216 W Walnut St
Ste A
Danville, KY 40422
Phone (859) 239-5870

217 S 3rd St
Danville, KY 40422
Phone (859) 239-1000

466 Linden Ave
#A
Harrodsburg, KY 40330
Phone (859) 734-5173

Organizations & group practices 7

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 9

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": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1356735484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-316-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENZMAN",
        "first_name": "RONALD",
        "middle_name": "CAMERON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MT224142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.