Individual provider Active NPI

Andres Fidel Henriquez, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Pembroke Pines, FL
National Provider Identifier
1629429261
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME156949 Issued in FL
Practice address
10796 Pines Blvd Ste 103
Pembroke Pines, FL 33026-3919
Phone
(954) 442-1402
Fax
(954) 442-1418
NPI assigned
Jun 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.068235 IL
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 65589 MN
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME156949 FL Primary

Addresses

Primary practice location

10796 Pines Blvd Ste 103
Pembroke Pines, FL 33026-3919

Mailing address

10796 Pines Blvd Ste 103
Pembroke Pines, FL 33026-3919
Phone (954) 442-1402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220926001600 FL Practitioner - Endocrinology 9234422171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fidel Hernando Henriquez MD PAGroup PAC ID 1951301845, 2 clinicians

Practice addresses (Care Compare)

10796 Pines Blvd
Suite 103
Pembroke Pines, FL 33026-3919
Phone (954) 442-1402

Hospital & facility affiliations

  • Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
  • Memorial Hospital Miramar Hospital, Miramar, FL, CCN 100285
  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038
  • Memorial Hospital Pembroke Hospital, Pembroke Pines, FL, CCN 100230

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.068235ILMDInternal Medicine Physician
ME156949FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fidel Hernando Henriquez MD PA Endocrinology, Diabetes & Metabolism CurrentSince Sep 22, 2022 Accepting new patients

Locations

10796 Pines Blvd
Ste 103
Pembroke Pines, FL 33026
Phone (954) 442-1402

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AIHBDD/Endpoint/AIHBDD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1629429261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10796 PINES BLVD STE 103",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263919",
            "telephone_number": "954-442-1402",
            "fax_number": "954-442-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10796 PINES BLVD STE 103",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263919",
            "telephone_number": "954-442-1402",
            "fax_number": "954-442-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIQUEZ",
        "first_name": "ANDRES",
        "middle_name": "FIDEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-24",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.068235",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MN",
            "license": "65589",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME156949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.