Carla R Henke, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

308608 Issued in NY

Practice address

1021 Broadway St
Buffalo, NY 14212-1460

Phone

(716) 529-3020

Fax

(716) 529-3040

NPI assigned

May 21, 2008

Sex

Female

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 NY

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

Family Practice

Education

State University of New York at Buffalo School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jericho Road Ministries, Inc.Group PAC ID 5597992933, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carla.henke@jrchc.medentdirect.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.

• Jericho Road Ministries Inc.

  • Federally Qualified Health Center (FQHC)
  • Buffalo, NY
  • NPI 1972944080
  Medicare reassignment Care Compare group NPD
• Kaleida Health

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1245365196
  NPD (past)
• Kaleida Health

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1639209596
  NPD (past)

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1508023037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 BROADWAY ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142121460",
            "telephone_number": "716-529-3920",
            "fax_number": "716-529-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 BROADWAY ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142121460",
            "telephone_number": "716-529-3020",
            "fax_number": "716-529-3040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3912 Georgia Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200115861",
            "country_code": "US",
            "telephone_number": "202-483-8196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Atlantic St SW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200322350",
            "country_code": "US",
            "telephone_number": "202-483-8196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENKE",
        "first_name": "CARLA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD040004",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "308608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shana Henderson
• Craig Matthew Hendler, MD
• Elizabeth Ann Hendricks, M.D.
• Zechariah Mark Hendrix-Ingalls
• Dane Hendry, DDS
• Jewell Ann Henley, MD
• Kathleen Lynn Henneberger, D.C.
• Emily C Hennessy, RPA-C
• Kevin Hennessy, NURSE PRACTITIONER
• Finn Hennig, MD

• Family Medicine Physician in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.