Jay A Hendrickson, M.D.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

G83722 Issued in CA

Practice address

729 Sunrise Ave Ste 602
Roseville, CA 95661-4542

Phone

(916) 953-7571

Fax

(916) 771-8515

NPI assigned

May 17, 2006

Last updated

Dec 12, 2023By the provider in NPPES

Sex

Male

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 CA

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

Specialty

Interventional Pain ManagementAlso: Anesthesiology

Education

Medical College of Pennsylvania, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Pain Diagnostic and Solutions IncGroup PAC ID 2264695196, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jay.hendrickson.p1@direct.apdss.nextgenshare.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.

• Advanced Pain Diagnostic & Solutions, Inc.

  • Pain Clinic/Center
  • Roseville, CA
  • NPI 1427322635
  Medicare reassignment Care Compare group NPD
• Hendrickson and Hunt Pain Management

  • Pain Medicine (Anesthesiology) Physician
  • Folsom, CA
  • NPI 1093919854
  Authorized official Same address or phone
• Marshall Medical Center

  dba Marshall Home Care

  • Home Health Agency
  • Diamond Springs, CA
  • NPI 1992705040
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1457304016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 EAST BIDWELL ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303455",
            "telephone_number": "916-984-3899",
            "fax_number": "916-984-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 SUNRISE AVE STE 602",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614542",
            "telephone_number": "916-953-7571",
            "fax_number": "916-771-8515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2350 E Bidwell St",
            "address_purpose": "LOCATION",
            "city": "Folsom",
            "state": "CA",
            "postal_code": "956303455",
            "country_code": "US",
            "telephone_number": "916-984-3899",
            "fax_number": "916-984-6522",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Plaza Dr Ste 160",
            "address_purpose": "LOCATION",
            "city": "Folsom",
            "state": "CA",
            "postal_code": "956304746",
            "country_code": "US",
            "telephone_number": "916-953-7571",
            "fax_number": "916-771-8515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "JAY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "G83722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G83722",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Henderson
• Lorre T Henderson, MD
• Hendricks Medical Corporation
• Ed Jerald Hendricks, M.D.
• Lynn Michele Hendrickson-Andres, MS, CCC-SLP
• Artur Z. Henke, MD
• Larsen Henken, M.S.
• Betsy Hennessy, RD,CSR
• Samuel Henning
• Megan Henriquez

• Interventional Pain Medicine Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.