Individual provider Active NPI

Brett R Henderson, M.D.

  • Neurological Surgery Physician
  • Las Cruces, NM
National Provider Identifier
1598818189
Registry record updated Jun 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
2001-213 Issued in NM
Practice address
3850 E Lohman Ave
Suite C
Las Cruces, NM 88011-8288
Phone
(575) 522-1974
Fax
(575) 522-5209
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 2001-213 NM Primary
Surgery Physician 208600000X 2001-213 NM

Addresses

Primary practice location

3850 E Lohman Ave
Suite C
Las Cruces, NM 88011-8288

Mailing address

PO Box 13668
Las Cruces, NM 88013-3668
Phone (575) 522-1974

Other identifiers 3

IdentifierTypeStateIssuer
F1792MedicaidNM
NM019Y53OtherNMBCBS OF NEW MEXICO
P00459212OtherNMRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20040503000155 NM Practitioner - NeurosurgeryPractitioner - General Surgery 1456349273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurosurgeryAlso: General Surgery
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2560 Samaritan Dr
Suite 101
Las Cruces, NM 88001-1170
Phone (575) 265-0222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.39 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
64.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion102
Laminectomy or laminotomy (partial removal of spine bones)113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2001-213NMMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern New Mexico Neurosurgery LLC Neurological Surgery CurrentSince Jan 1, 2008 Accepting new patients
Southern New Mexico Diagnostics LLC PastSince Mar 1, 2012 Accepting new patients
Las Cruces Physician Services LLC Neurological Surgery PastSince May 1, 2007 Accepting new patients
Function Therapy Specialists, Inc Past Accepting new patients
Familycare Associates,PA Past Accepting new patients

Locations

2560 Samaritan Dr
Ste 101
Las Cruces, NM 88001
Phone (575) 265-0222

2550 Samaritan Dr
Ste 101
Las Cruces, NM 88001
Phone (575) 265-0222

3850 E Lohman Ave
Ste C
Las Cruces, NM 88011
Phone (575) 522-1974

205 W Boutz Rd
Las Cruces, NM 88005
Phone (575) 915-1550

1755 Curie Dr
Ste A
El Paso, TX 79902
Phone (915) 534-1329

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1598818189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13668",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880133668",
            "telephone_number": "575-522-1974",
            "fax_number": "575-522-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 E LOHMAN AVE",
            "address_2": "SUITE C",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118288",
            "telephone_number": "575-522-1974",
            "fax_number": "575-522-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "BRETT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NM",
            "license": "2001-213",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "2001-213",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F1792",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NEW MEXICO",
            "identifier": "NM019Y53",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00459212",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.