Active NPI
Carson Henderson, PA
- Physician Assistant
- Lantana, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9118746
- Practice address
- 928 S Dixie Hwy Unit 470
Lantana, FL 33462-4653 - Phone
- (561) 794-5068
- NPI assigned
- Apr 4, 2024
- Last updated
- Apr 5, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA66190 | CA | |
| Physician Assistant | 363A00000X | 0110010390 | VA | |
| Physician Assistant | 363A00000X | PA9118746 | FL | Primary |
Addresses
Primary practice location
928 S Dixie Hwy Unit 470
Lantana, FL 33462-4653
Mailing address
928 S Dixie Hwy Unit 470
Lantana, FL 33462-4653
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
951 N Washington Ave
Titusville, FL 32796-2194
Phone (321) 268-6111
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA66190 | CA | MD | Physician Assistant |
| 0110010390 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inphynet Contracting Services LLC | Physician Assistant | Current | Accepting new patients |
| Precision Hormone Replacement Inc | Physician Assistant | Current | Accepting new patients |
| Tenet Florida Physician Services LLC | Current | Accepting new patients | |
| Tenet Florida Physician Services II, LLC | Current | Accepting new patients | |
| Precision Medical BHRT Inc | Past | Accepting new patients |
Locations
3000 Bayview Dr
Ft Lauderdale, FL 33306
Phone (954) 393-1708
928 S Dixie Hwy
Lantana, FL 33462
Phone (561) 794-5068
901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300
1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608
951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511
Organizations & group practices 7
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743811200000",
"number": "1801648621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "928 S DIXIE HWY UNIT 470",
"city": "LANTANA",
"state": "FL",
"postal_code": "334624653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "928 S DIXIE HWY UNIT 470",
"city": "LANTANA",
"state": "FL",
"postal_code": "334624653",
"telephone_number": "561-794-5068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "CARSON",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-04",
"last_updated": "2025-04-05",
"certification_date": "2025-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA66190",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110010390",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9118746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lantana, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2025; 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.