Organization Active NPI

Bert J. Henkel, DPM, PA

  • Podiatric Clinic/Center
  • Hollywood, FL
National Provider Identifier
1427340041
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
License
PO2555 Issued in FL
Legal business name
BERT J. HENKEL, DPM, PA
Practice address
4301 Hollywood Blvd
Hollywood, FL 33021-6634
Phone
(954) 981-8000
Fax
(954) 981-8002
NPI assigned
May 16, 2011
Last updated
May 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2011

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

Authorized official

Name
Dr. Bert J Henkel, DPMNPI 1477519338
Title
President
Phone
(954) 981-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X PO2555 FL Primary

Addresses

Primary practice location

4301 Hollywood Blvd
Hollywood, FL 33021-6634

Mailing address

4301 Hollywood Blvd
Hollywood, FL 33021-6634
Phone (954) 981-8000

Other identifiers 1

IdentifierTypeStateIssuer
390388500MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110606000541 FL Part B Supplier - Clinic/Group Practice 6204013972 Receives reassigned benefits from 1 practitioner
Practice locations: Hollywood, FL

National Provider Directory

National Provider Directory

Locations

4301 Hollywood Blvd
Hollywood, FL 33021
Phone (954) 981-8000

4301 Hollywood Blvd
#1054
Hollywood, FL 33021

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305504000000",
    "number": "1427340041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216634",
            "telephone_number": "954-981-8000",
            "fax_number": "954-981-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216634",
            "telephone_number": "954-981-8000",
            "fax_number": "954-981-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERT J. HENKEL, DPM, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-16",
        "last_updated": "2011-05-16",
        "status": "A",
        "authorized_official_last_name": "HENKEL",
        "authorized_official_first_name": "BERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-981-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "FL",
            "license": "PO2555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390388500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.