Gary L Henderson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

0529 Issued in AZ

Practice address

1775 W St Marys Rd
Suite 116
Tucson, AZ 85745

Phone

(520) 624-2471

Fax

(520) 882-7469

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

General Surgery

Education

University of Alabama School of Medicine, 1963

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sunbelt Medical Group LLCGroup PAC ID 4082983465, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. Mary'S Hospital Hospital, Tucson, AZ, CCN 030010

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Gary Henderson, MD PC

  • Surgery Physician
  • Tucson, AZ
  • NPI 1083895106
  Medicare reassignment NPD Authorized official
• Sunbelt Medical Group LLC

  • Clinic/Center
  • Tucson, AZ
  • NPI 1104354752
  Medicare reassignment Care Compare group NPD
• Sunbelt Medical Group LLC

  • Foot & Ankle Surgery Podiatrist
  • Tucson, AZ
  • NPI 1568213700
  NPD
• Doctor S Group Inc

  • Family Medicine Physician
  • Tucson, AZ
  • NPI 1710206461
  NPD (past)
• Family Care Facility Network Corp

  • Family Medicine Physician
  • Tucson, AZ
  • NPI 1467771113
  NPD (past)

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

• SMSJ Tucson Holdings LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1265818488
  Care Compare affiliation

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1801969498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 W ST MARYS RD",
            "address_2": "SUITE 116",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85745",
            "telephone_number": "520-624-2471",
            "fax_number": "520-882-7469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 W ST MARYS RD",
            "address_2": "SUITE 116",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85745",
            "telephone_number": "520-624-2471",
            "fax_number": "520-882-7469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "GARY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "0529",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "3322",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217423",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharifa O Hemat, FNP
• Ziad Hemzawi, MD
• Helene Patricia Henager, N.P.
• Hana Bassem Hendawy, MD, MB, BCH, BAO
• Anthony L Henderson, PT
• Heather Henderson, RN
• Helen M Henderson, LCSW
• Judith Henderson, LCSW
• Kathleen N Henderson, APRN
• Lisa Anne Henderson, MA, ED.S

• Surgery Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.