Bradley Henriksen, M.D.

Primary specialty

Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X

License

11598920-1205 Issued in UT

Practice address

1735 N State St
Provo, UT 84604-1010

Phone

(801) 374-1818

NPI assigned

Aug 5, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Ophthalmology

Education

University of Utah School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Utah Eye AssociatesGroup PAC ID 3577464908, 17 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.79 of 100Reported as group

Quality

81.55

Promoting interoperability

100

Improvement activities

40

Cost

74.42

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bradley.henriksen.p1@direct.exceleyecenter.nextgenshare.com

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.

• Central Utah Eye Associates

  • Ophthalmology Physician
  • Provo, UT
  • NPI 1992722888
  Medicare reassignment Care Compare group NPD
• Odan LLC

  • Physical Therapy Clinic/Center
  • Spanish Fork, UT
  • NPI 1194560888
  NPD (past)

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1467838094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 N STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041010",
            "telephone_number": "801-374-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 N STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041010",
            "telephone_number": "801-374-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIKSEN",
        "first_name": "BRADLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-05",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "UT",
            "license": "11598920-1205",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "MD193060",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dallin Grant Hendry
• Lilliam Henningson, LCSW
• Bryan Andrew Henrie
• Jason D Henrie
• Patricia Henrie, PH.D., LPC
• Emilee Henriquez, LCMHC
• Caroline Henry
• Isabelle Henry
• Erica R Hensman, PA-C
• Jared Hepworth

• Pediatric Ophthalmology and Strabismus Specialist Physician in Provo, UT
• Providers in Provo, UT by specialty
• Pediatric Ophthalmology and Strabismus Specialist Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.