Individual provider Active NPI

Robert P Hendrikson, MD

  • Orthopaedic Surgery Physician
  • Waterbury, CT
National Provider Identifier
1689755910
Registry record updated Jul 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
021059 Issued in CT
Practice address
60 Westwood Ave
Suite 300
Waterbury, CT 06708
Phone
(203) 755-9166
Fax
(203) 755-5932
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 021059 CT Primary

Addresses

Primary practice location

60 Westwood Ave
Suite 300
Waterbury, CT 06708

Mailing address

60 Westwood Ave
Suite 300
Waterbury, CT 06708
Phone (203) 755-9166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20101014000736 CT Practitioner - Orthopedic Surgery 0042104796

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021059CTMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert P Hendrikson MD PC Current Accepting new patients

Locations

60 Westwood Ave
Ste 300
Waterbury, CT 06708
Phone (203) 597-1609

Interoperability endpoints

  • Direct secure messaging: rhendrikson@direct.wtbyhosp.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278979200000",
    "number": "1689755910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WESTWOOD AVE",
            "address_2": "SUITE 300",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06708",
            "telephone_number": "203-755-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 WESTWOOD AVE",
            "address_2": "SUITE 300",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06708",
            "telephone_number": "203-755-9166",
            "fax_number": "203-755-5932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIKSON",
        "first_name": "ROBERT",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CT",
            "license": "021059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.