NPIMap

Individual provider Active NPI

Tarah L Henderson-Toderic, DO

  • Family Medicine Physician
  • El Paso, TX
National Provider Identifier
1669950879
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
W7620 Issued in TX
Practice address
2000 Transmountain Rd Ste B
El Paso, TX 79911-3602
Phone
(915) 215-8400
Fax
(915) 612-9254
NPI assigned
Jul 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X W7620 TX Primary
Family Medicine Physician 207Q00000X 0102209788 VA
Sports Medicine (Family Medicine) Physician 207QS0010X W7620 TX
Family Medicine Physician 207Q00000X 85873 GA
Sports Medicine (Family Medicine) Physician 207QS0010X 2572 AL

Addresses

Primary practice location

2000 Transmountain Rd Ste B
El Paso, TX 79911-3602

Mailing address

56-117 Pualalea St
Kahuku, HI 96731-2052
Phone (808) 293-6236

Other practice location 1

56-117 Pualalea St
Kahuku, HI 96731-2052
Phone (706) 414-4731

Other practice location 2

436 Clairmont Ct Ste 100
Colonial Heights, VA 23834-1765
Phone (804) 526-2121

Other practice location 3

9849 Kenworthy St
El Paso, TX 79924-4402
Phone (915) 215-5500

Other names 1

  • Tarah Henderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240620003957 HI Practitioner - Internal MedicinePractitioner - Sports Medicine 8729424403 Reassigns benefits to 1 organization
I20251202000174 VA Practitioner - Family Practice 8729424403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bon Secours Medical Group Richmond Primary Care LLCGroup PAC ID 3476986613, 91 clinicians

Practice addresses (Care Compare)

1362 Tappahannock Blvd
Tappahannock, VA 22560-9309
Phone (804) 443-5378

436 Clairmont CT
Suite 100
Colonial Heights, VA 23834-1765
Phone (804) 526-2121

Hospital & facility affiliations

  • Bon Secours Southside Medical Center Hospital, Petersburg, VA, CCN 490067
  • Kahuku Medical Center Hospital, Kahuku, HI, CCN 121304
  • Adventist Health Castle Hospital, Kailua, HI, CCN 120006
  • Bon Secours St Francis Medical Center Hospital, Midlothian, VA, CCN 490136

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2572ALMDRegistered Dietitian
85873GAMDFamily Medicine Physician
0102209788VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kahuku Medical Center Current Accepting new patients
Bon Secours Medical Group Richmond Primary Care LLC Family Medicine CurrentSince Dec 15, 2025 Accepting new patients
Phoebe Putney Memorial Hospital Family Medicine Past Accepting new patients
Commonwealth Counseling Associates Inc Past Accepting new patients
Kahuku Medical Center Past Accepting new patients

Locations

56-117 Pualalea St
Kahuku, HI 96731
Phone (808) 293-9221

436 Clairmont Ct
Ste 100
Colonial Hgts, VA 23834
Phone (804) 526-2121

1362 Tappahannock Blvd
Tappahannock, VA 22560
Phone (804) 443-5378

Interoperability endpoints

  • Direct secure messaging: thenderson726904@direct.ochin.org
  • Direct secure messaging: thendersontoderic3087095@direct.bsmhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1669950879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56-117 PUALALEA ST",
            "city": "KAHUKU",
            "state": "HI",
            "postal_code": "967312052",
            "telephone_number": "808-293-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 TRANSMOUNTAIN RD STE B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799113602",
            "telephone_number": "915-215-8400",
            "fax_number": "915-612-9254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "56-117 Pualalea St",
            "address_purpose": "LOCATION",
            "city": "Kahuku",
            "state": "HI",
            "postal_code": "967312052",
            "country_code": "US",
            "telephone_number": "706-414-4731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "436 Clairmont Ct Ste 100",
            "address_purpose": "LOCATION",
            "city": "Colonial Heights",
            "state": "VA",
            "postal_code": "238341765",
            "country_code": "US",
            "telephone_number": "804-526-2121",
            "fax_number": "804-504-4634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9849 Kenworthy St",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799244402",
            "country_code": "US",
            "telephone_number": "915-215-5500",
            "fax_number": "915-215-8655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON-TODERIC",
        "first_name": "TARAH",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "W7620",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102209788",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "W7620",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "85873",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AL",
            "license": "2572",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARAH",
            "last_name": "HENDERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.