Individual provider Active NPI

James Edward Henry, DO PC AOAOS

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Far Rockaway, NY
National Provider Identifier
1366550691
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
183060 Issued in NY
Practice address
347 Beach 19TH Street
Far Rockaway, NY 11691
Phone
(718) 869-8888
Fax
(718) 869-8893
NPI assigned
Aug 28, 2006
Last updated
Feb 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 183060 NY Primary

Addresses

Primary practice location

347 Beach 19TH Street
Far Rockaway, NY 11691

Mailing address

347 Beach 19TH Street
Far Rockaway, NY 11691
Phone (718) 869-8888

Other practice location 1

327 Beach 19th St
Far Rockaway, NY 11691-4423
Phone (718) 869-7690

Other identifiers 2

IdentifierTypeStateIssuer
13292OtherNYMEDICARE PAYOR ID
01642126MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20061110000117 NY Practitioner - Orthopedic Surgery 7810995651 Practice locations: Far Rockaway, NY

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St John's Medical Services PC CurrentSince Apr 22, 2009 Accepting new patients
South Beach Medical PC Past Accepting new patients
South Island Orthopaedic Group, P.C. Past Accepting new patients
South Island Orthopedics, P.C. Past Accepting new patients

Locations

131 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 688-0200

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

431 Beach 20th St
Far Rockaway, NY 11691
Phone (718) 327-2700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14448/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1366550691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 BEACH 19TH STREET",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "11691",
            "telephone_number": "718-869-8888",
            "fax_number": "718-869-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 BEACH 19TH STREET",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "11691",
            "telephone_number": "718-869-8888",
            "fax_number": "718-869-8893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "327 Beach 19th St",
            "address_purpose": "LOCATION",
            "city": "Far Rockaway",
            "state": "NY",
            "postal_code": "116914423",
            "country_code": "US",
            "telephone_number": "718-869-7690",
            "fax_number": "844-296-7778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRY",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "credential": "DO PC AOAOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NY",
            "license": "183060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PAYOR ID",
            "identifier": "13292",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01642126",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.