Individual provider Active NPI

Karl A Hendrickson, MD

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1477524627
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
16745 Issued in AZ
Practice address
7600 N 16TH St
Suite 150
Phoenix, AZ 85020-4431
Phone
(602) 395-0718
Fax
(602) 277-8146
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 16745 AZ Primary

Addresses

Primary practice location

7600 N 16TH St
Suite 150
Phoenix, AZ 85020-4431

Mailing address

PO Box 39179
Phoenix, AZ 85069-9179
Phone (602) 395-0718

Other identifiers 1

IdentifierTypeStateIssuer
277675MedicaidAZ

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20051020000697 AZ Practitioner - AnesthesiologyPractitioner - Pain Management 9234114109 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16745AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Karl Hendrickson MD PC Anesthesiology CurrentSince Jun 15, 2003 Accepting new patients
Squaw Peak Anesthesia Inc Past Accepting new patients
Gads Pain Management LLC Past Accepting new patients
Valley Anesthesiology Consultants, Inc. Anesthesiology Past Accepting new patients

Locations

4545 N Hunt Hwy
#F
Florence, AZ 85132
Phone (520) 868-3333

1040 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-5133

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

1111 E McDowell Rd
Ste B
Phoenix, AZ 85006
Phone (602) 346-0350

7600 N 16th St
Ste 150
Phoenix, AZ 85020
Phone (602) 395-0178

Interoperability endpoints

  • Direct secure messaging: gehkhendr@yourcarecommunity.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1477524627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39179",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850699179",
            "telephone_number": "602-395-0718",
            "fax_number": "602-277-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 N 16TH ST",
            "address_2": "SUITE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204431",
            "telephone_number": "602-395-0718",
            "fax_number": "602-277-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "KARL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "16745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277675",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.