Melissa A Henderson, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003792A Issued in IN

Practice address

2222 W Lexington Ave
Elkhart, IN 46514-1420

Phone

(574) 294-3030

Fax

(574) 296-3544

NPI assigned

Jun 17, 2013

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group Indiana LLCGroup PAC ID 2365341674, 28 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: melissa.henderson.1@31626.direct.athenahealth.com
• Direct secure messaging: melissa.henderson@elkhartc.eclinicaldirectplus.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.

• Privia Medical Group Indiana, LLC

  • Multi-Specialty Clinic/Center
  • Elkhart, IN
  • NPI 1013912286

  Optometrist

  Medicare reassignment Care Compare group NPD
• Privia Medical Group Indiana, LLC

  • Family Nurse Practitioner
  • Wakarusa, IN
  • NPI 1568147809
  NPD
• Aeg Indiana Professional PC

  • Optometrist
  • Warsaw, IN
  • NPI 1043944127
  NPD (past)

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376982074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2968",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465152968",
            "telephone_number": "574-296-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W LEXINGTON AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141420",
            "telephone_number": "574-294-3030",
            "fax_number": "574-296-3544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "927 Keenan Ct",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466153660",
            "country_code": "US",
            "telephone_number": "440-541-9694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MELISSA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003792A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201201560",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Helfrich
• Arianna Helgesen
• Hellenic Senior Living of Elkhart, LLC (Hellenic Senior Living of Elkhart)
• Emma Helmuth
• James H Hemry, PHD HSPP
• Pleas V. Henderson Jr., CRNA
• Hendricks Chiropractic PC (Amberwood Terrace Chiropractic)
• Hendricks County Hospital (Brickyard Healthcare - Elkhart Care Center)
• Derrick R Hendricks, D.C.
• Mary G Henehan, LCSW

• Optometrist in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.