Individual provider Active NPI

Jennifer Burk Henderson, PA-C

  • Medical Physician Assistant
  • Sugar Land, TX
National Provider Identifier
1548561871
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1327 Lake Pointe Pkwy Ste 416
Sugar Land, TX 77478-3499
Phone
(281) 494-0050
NPI assigned
Nov 3, 2010
Last updated
Nov 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

1327 Lake Pointe Pkwy Ste 416
Sugar Land, TX 77478-3499

Mailing address

1327 Lake Pointe Pkwy Ste 416
Sugar Land, TX 77478-3499
Phone (281) 494-0050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101208000732 TX Practitioner - Physician Assistant 3870780455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

1367 Dominion PLZ
Tyler, TX 75703-1013
Phone (903) 534-6200

5420 W Loop S
Suite 4500
Bellaire, TX 77401-2122
Phone (713) 529-8787

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
David W Powell MD Dermatology PA Medical PastSince Nov 8, 2020 Accepting new patients
Simpar Medical Research Past Accepting new patients
Komal F Stoerr Mdpa Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1548561871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 LAKE POINTE PKWY STE 416",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783499",
            "telephone_number": "281-494-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 LAKE POINTE PKWY STE 416",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783499",
            "telephone_number": "281-494-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JENNIFER",
        "middle_name": "BURK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-03",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.