Mark William Henry, MS, RPA-C, ATC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

015279 Issued in NY

Practice address

205 S Orange Ave
C-Level #1200
Newark, NJ 07103-2785

Phone

(973) 972-8240

Fax

(973) 972-9367

NPI assigned

Jun 5, 2006

Last updated

Mar 9, 2016By 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 4

Addresses

Other identifiers 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, 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.

• Icahn School of Medicine at Mount Sinai

  dba Orthopedic Department of Mount Sinai

  • Orthopaedic Surgery Physician
  • New York, NY
  • NPI 1124550280
  Medicare reassignment Care Compare group
• Icahn School of Medicine at Mount Sinai

  dba Environmental Medicine at Mount Sinai

  • Occupational Medicine Clinic/Center
  • New York, NY
  • NPI 1427493113
  NPD
• Icahn School of Medicine at Mount Sinai

  dba New York Eye & Ear Optical Shop

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• University Physician Associates of New Jersey Inc

  dba University Orthopaedic Associates

  • Orthopaedic Surgery Physician
  • Newark, NJ
  • NPI 1164432761
  NPD (past)
• Icahn School of Medicine at Mount Sinai

  dba OB/GYN Department of Mount Sinai

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1124392212
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1578502779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S ORANGE AVE",
            "address_2": "C-LEVEL #1200",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032785",
            "telephone_number": "973-972-6500",
            "fax_number": "973-972-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S ORANGE AVE",
            "address_2": "C-LEVEL #1200",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032785",
            "telephone_number": "973-972-8240",
            "fax_number": "973-972-9367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "MS, RPA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015279",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": "1098952",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00331900",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1098952",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT",
            "identifier": "015279",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Henlucy Health System LLC
• Henlucy Transportation
• Sara Henriques
• Danuta Henriquez, LPN
• Edens Henrisse, LMT
• Yokasta Herasme
• Yasheika Hermitt South
• Daniel A Hernaiz, MSN, APN
• Yohan Hernandez Flores, FNP
• Laura Maria Hernandez Perez, MD

• Physician Assistant in Newark, NJ
• Providers in Newark, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.