Kimberly Jill Henderson, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

278817 Issued in NY

Practice address

334 Plaza Rd
Kingston, NY 12401-2975

Phone

(845) 338-5575

NPI assigned

Jun 17, 2011

Last updated

Jan 24, 2017By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Obstetrics/Gynecology

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nuvance Health Medical Practice PCGroup PAC ID 1658468442, 578 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Dutchess Hospital Hospital, Rhinebeck, NY, CCN 330049
• Vassar Brothers Medical Center Hospital, Poughkeepsie, NY, CCN 330023
• Healthalliance Hospital Marys Avenue Campus Hospital, Kingston, NY, CCN 330224

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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

• Nuvance Health Medical Practice PC

  • Internal Medicine Physician
  • Poughkeepsie, NY
  • NPI 1437358033

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Sun River Health Inc

  • Federally Qualified Health Center (FQHC)
  • Amenia, NY
  • NPI 1568526838
  Medicare reassignment NPD
• Sun River Health Inc

  • Adult Day Care Clinic/Center
  • Bronx, NY
  • NPI 1740763275
  NPD
• Sun River Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Peekskill, NY
  • NPI 1619969458
  NPD

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

• Healthalliance Hospital Marys Avenue Campus

  • General Acute Care Hospital
  • Kingston, NY
  • NPI 1932182599
  Care Compare affiliation
• Northern Dutchess Hospital

  • General Acute Care Hospital
  • Rhinebeck, NY
  • NPI 1124072715
  Care Compare affiliation
• Vassar Brothers Hospital

  • General Acute Care Hospital
  • Poughkeepsie, NY
  • NPI 1740233899
  Care Compare affiliation
• Vassar Brothers Medical Center

  dba Vassar Diagnostics

  • Clinical Medical Laboratory
  • Poughkeepsie, NY
  • NPI 1780052514

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1790070787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 ROUTE 55",
            "address_2": "SUITE 200",
            "city": "LAGRANGEVILLE",
            "state": "NY",
            "postal_code": "125405108",
            "telephone_number": "845-475-9661",
            "fax_number": "845-475-9938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 PLAZA RD",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012975",
            "telephone_number": "845-338-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KIMBERLY",
        "middle_name": "JILL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-17",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "278817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04091058",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Patrick Healy, LMHC, LBA, BCBA
• Thomas Edward Heinlein, RN
• Louis I Heller, MD
• Ariel Helman
• Marsha L Helmer, C.O.T.A.
• Katherine Grace Henri, LMSW
• Andrea K Henry, PSY.D.
• Tiphonie Henry, LMSW
• Tabitha L Henson, LCSW
• Heritage Services

• Obstetrics & Gynecology Physician in Kingston, NY
• Providers in Kingston, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.