Michael Dwayne Henderson, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

Q9636 Issued in TX

Practice address

1900 Scenic Dr
Suite 3308
Georgetown, TX 78626-7724

Phone

(512) 869-2566

Fax

(512) 869-7434

NPI assigned

Jul 12, 2007

Last updated

Feb 10, 2022By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, VI, PA, IA4 enrollments

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 4

Specialty

Cardiovascular Disease (Cardiology)

Education

University of Virginia School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Governor Juan F Luis Hospital and Medical CenterGroup PAC ID 1153233804, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gov Juan F Luis Hospital & Medical Ctr Hospital, St Croix, VI, CCN 480002

Merit-based Incentive Payment System (MIPS)

Final score

98.3 of 100Reported as group

Promoting interoperability

98

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: 2562-henderson-michael@direct.leadingreach.com
• Direct secure messaging: mhenderson10255@epiccwdv.hcadirect.net
• Direct secure messaging: smmmhende@yourcarecommunity.org

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.

• Governor Juan F. Luis Hospital & Medical Center

  • General Acute Care Hospital
  • Christiansted, St. Croix, VI
  • NPI 1972503647
  Medicare reassignment Care Compare group NPD
• Susquehanna Physician Services

  dba Susquehanna Health Medical Group

  • Cardiovascular Disease Physician
  • Williamsport, PA
  • NPI 1861431116
  Medicare reassignment NPD
• Central Iowa Hospital Corporation

  dba East Des Moines Family Care Center

  • Family Medicine Physician
  • Des Moines, IA
  • NPI 1104879576
  Medicare reassignment
• Columbus Community Hospital

  • Rural Acute Care Hospital
  • Columbus, TX
  • NPI 1740238641
  NPD
• Columbus Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Columbus, TX
  • NPI 1881713477
  NPD
• Governor Juan F. Luis Hospital & Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • St Croix, VI
  • NPI 1740238534
  NPD
• Susquehanna Physician Services

  • Radiology Clinic/Center
  • Mansfield, PA
  • NPI 1073361564
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Governor Juan F. Luis Hospital & Medical Center

  • General Acute Care Hospital
  • Christiansted, St. Croix, VI
  • NPI 1972503647
  Care Compare affiliation

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1518166354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SAINT MARKS PL STE 160",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789451253",
            "telephone_number": "979-242-5677",
            "fax_number": "979-242-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SCENIC DR",
            "address_2": "SUITE 3308",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786267724",
            "telephone_number": "512-869-2566",
            "fax_number": "512-869-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MICHAEL",
        "middle_name": "DWAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "Q9636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhenderson10255@epiccwdv.hcadirect.net",
            "affiliation": "N",
            "address_1": "1900 Scenic Dr",
            "address_2": "SUITE 3308",
            "city": "Georgetown",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786267724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shawna Leigh Hein, ATC
• Theodore N Held, M.D.
• John William Hellerstedt
• Holly C Helms, MD
• Kayelen Helton
• Kennedy Hendley
• Chad Patrick Hennessey, ATC, LAT
• David R Hennington, DDS
• Kayla R Henry
• Jennifer Anne Hensley, FNP-C

• Cardiovascular Disease Physician in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Cardiovascular Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.