Marissa Anne Hendrickson, M.D.

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

50851 Issued in MN

Practice address

401 E River Pkwy
Pediatric Emergency Medicine, 76 VCRC
Minneapolis, MN 55455-0368

Phone

(612) 625-6678

Fax

(612) 626-1144

NPI assigned

May 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Merit-based Incentive Payment System (MIPS)

Final score

96.44 of 100Reported as group

Quality

82.65

Promoting interoperability

100

Improvement activities

40

Cost

77.21

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mhendrickson73189@fairview.direct-ci.com

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.

• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• University of Minnesota Health Clinics and Surgery Center, Inc.

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1053795187
  Medicare reassignment NPD
• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Express Care

  • Specialist
  • Saint Paul, MN
  • NPI 1679048763
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• University of Minnesota Health Clinics and Surgery Center Inc

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1003485004
  NPD
• University of Minnesota Pediatric Dental Clinic

  • Dentist
  • Minneapolis, MN
  • NPI 1992075287
  NPD
• University of Minnesota Physicians

  • Dental Clinic/Center
  • Minneapolis, MN
  • NPI 1952546061
  NPD
• Childrens Research Foundation of Cleveland

  • Pediatrics Physician
  • Cleveland, OH
  • NPI 1881634665

  Pediatric Emergency Medicine

  NPD (past)

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1770797151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E RIVER PKWY",
            "address_2": "PEDIATRIC EMERGENCY MEDICINE, 76 VCRC",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550368",
            "telephone_number": "612-625-6678",
            "fax_number": "612-626-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E RIVER PKWY",
            "address_2": "PEDIATRIC EMERGENCY MEDICINE, 76 VCRC",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550368",
            "telephone_number": "612-625-6678",
            "fax_number": "612-626-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "MARISSA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MN",
            "license": "50851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Kirsten Henderson, DNP, ARPN, WHNP-BC
• David Alton Hendrick, MD
• Alissa Amalia Hendrickson, PT
• Anne M Hendrickson, PA-C
• Kristine J Hendrickson, M.D.
• Nathan R. Hendrickson, MD, MS
• Steven Craig Hendrickson, CRNA
• Julia Heneghan
• Patricia Cecile Henjum, RN, CNP
• Craig Alan Henke, M.D.

• Pediatric Emergency Medicine (Pediatrics) Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.