NPIMap

Individual provider Active NPI

Gregory S Henderson, MD, PHD

  • Anatomic Pathology & Clinical Pathology Physician
  • Warwick, NY
National Provider Identifier
1407804859
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
273297 Issued in NY
Practice address
30 Wawayanda CT
Warwick, NY 10990-3346
Phone
(206) 790-2318
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 273297 NY Primary

Addresses

Primary practice location

30 Wawayanda CT
Warwick, NY 10990-3346

Mailing address

30 Wawayanda CT
Warwick, NY 10990-3346
Phone (206) 790-2318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150929001280 NY Practitioner - Pathology 6800872235 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Vanderbilt University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 241-8014

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2015 Accepting new patients
Icahn School of Medicine at Mount Sinai Anatomic Pathology & Clinical Pathology CurrentSince Aug 29, 2023 Accepting new patients
Fpa Hospital Based CurrentSince Jul 1, 2015 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 29, 2023 Accepting new patients
Pacific Pathology Partners, PLLC PastSince Apr 28, 2011 Accepting new patients
Pakc DSL Inc PS PastSince Jul 1, 2008 Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

5 E 98th St
Fl 6
New York, NY 10029
Phone (212) 241-2221

150 E 42nd St
New York, NY 10017
Phone (212) 661-8139

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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 6

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1407804859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WAWAYANDA CT",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109903346",
            "telephone_number": "206-790-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WAWAYANDA CT",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109903346",
            "telephone_number": "206-790-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "GREGORY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "273297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, NY

Sources for this page

Verify at the official NPI Registry.