Deborah L. Henderson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17812 Issued in CA

Practice address

72780 Country Club Dr
BLDG B 203
Rancho Mirage, CA 92270-4126

Phone

(760) 674-3847

Fax

(760) 674-3845

NPI assigned

May 22, 2006

Last updated

Mar 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Merit-based Incentive Payment System (MIPS)

Final score

96.69 of 100Reported as group

Quality

90

Improvement activities

40

Cost

78.43

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Hayward, CA
  • NPI 1194741462
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  NPD (past)
• Emergency Medicine Physician Partners of San Bernardino County, Inc

  • Emergency Medicine Physician
  • San Bernardino, CA
  • NPI 1225339294
  NPD (past)

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1558315515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72780 COUNTRY CLUB DR",
            "address_2": "BLDG B 203",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704126",
            "telephone_number": "760-674-3847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72780 COUNTRY CLUB DR",
            "address_2": "BLDG B 203",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704126",
            "telephone_number": "760-674-3847",
            "fax_number": "760-674-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "DEBORAH",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOOD SAMARITAN RAILROAD",
            "identifier": "P00246545",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA17812",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark C Heffernan, PH.D.
• Benjamin J Hegenbarth, D.O.
• Sheda Heidarian, M.D.
• Ronald Jeffrey Heilpern, MD
• Helping Hands Quality Home Care
• Jennifer Ann Henderson, PA-C
• Robin Gail Henderson, FNP-BC
• James Gregory Hendricks, M.D.
• Jeffrey Hensley, FNP
• John Herling, MD

• Physician Assistant in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.