Individual provider Active NPI

Michael Evan Henry, DPM

  • Podiatrist
  • Wilmington, DE
National Provider Identifier
1720173057
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E1000170 Issued in DE
Practice address
1010 North Bancroft Parkway
Suite 12
Wilmington, DE 19805-2668
Phone
(302) 658-1129
Fax
(302) 658-7646
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E1000170 DE Primary

Addresses

Primary practice location

1010 North Bancroft Parkway
Suite 12
Wilmington, DE 19805-2668

Mailing address

1010 North Bancroft Parkway
Suite 12
Wilmington, DE 19805-2668
Phone (302) 658-1129

Other identifiers 1

IdentifierTypeStateIssuer
1000036543MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050620000785 DE Practitioner - Podiatry 2567407653 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brandywine Podiatry PAGroup PAC ID 5597700682, 8 clinicians

Practice addresses (Care Compare)

1010 N Bancroft Pkwy
Suite 12
Wilmington, DE 19805-2668
Phone (302) 658-1129

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1266
Removal or shaving of skin growth626
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E1000170DEMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brandywine Podiatry, PA Podiatrist CurrentSince Jul 11, 2005 Accepting new patients
Brandywine Podiatry, PA Podiatrist CurrentSince Jul 11, 2005 Accepting new patients
Christiana Care Health Services Inc Podiatrist CurrentSince Jul 5, 2011 Accepting new patients
Christiana Care Health Services Inc CurrentSince Jul 5, 2011 Accepting new patients

Locations

121 Becks Woods Dr
Ste 201
Bear, DE 19701
Phone (302) 595-4077

1010 N Bancroft Pkwy
Ste 12
Wilmington, DE 19805
Phone (302) 658-1129

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411

Organizations & group practices 4

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 1

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1720173057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 NORTH BANCROFT PARKWAY",
            "address_2": "SUITE 12",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198052668",
            "telephone_number": "302-658-1129",
            "fax_number": "302-658-7646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 NORTH BANCROFT PARKWAY",
            "address_2": "SUITE 12",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198052668",
            "telephone_number": "302-658-1129",
            "fax_number": "302-658-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "MICHAEL",
        "middle_name": "EVAN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "DE",
            "license": "E1000170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000036543",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.