Maryann Raafat Henin, D.O.
Individual provider Active NPI Internal Medicine Physician · Rockledge, FL
NPI 1841633765 · NPPES record last updated Oct 18, 2023
Key facts
- NPI
- 1841633765
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- H0081497 (MD)
- Practice address
- 220 Barton Blvd Unit C-14
Rockledge, FL 32955-2742 - Phone
- (321) 241-6800
- Fax
- (321) 241-6890
- NPI assigned
- Apr 10, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 21
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- West Virginia School of Osteopathic Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Brevard Health Alliance Inc
Practice addresses (Care Compare)
2120 Sarno Rd
Melbourne, FL 32935-3084
Phone (321) 241-6800
220 Barton Blvd
Rockledge, FL 32955-2742
Phone (321) 241-6800
Hospital & facility affiliations
- Viera Hospital
- Cape Canaveral Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240607001675 | FL | Practitioner - Internal Medicine | 9032413851 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H0081497 | MD | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brevard Health Alliance Inc | Current |
Accepting new patients | |
| Brevard Health Alliance, Inc. | Current |
Accepting new patients | |
| Brevard Health Alliance Inc | Current | Accepting new patients | |
| Brevard Health Alliance Inc | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
905 Pineda St
Cocoa, FL 32922
775 Malabar Rd
Malabar, FL 32950
Phone (321) 722-8435
2120 Sarno Rd
Melbourne, FL 32935
Phone (321) 952-9696
17 Silver Palm Ave
Melbourne, FL 32901
Phone (321) 725-9041
7227 N US Highway 1
Port St John, FL 32927
Phone (321) 631-3693
220 Barton Blvd
Unit C14
Rockledge, FL 32955
Phone (321) 639-5177
1537 N Singleton Ave
Titusville, FL 32796
Phone (321) 268-0267
2000 Commerce Dr
West Melbourne, FL 32904
Phone (321) 676-6650
Interoperability endpoints
- maryann.henin@bha.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | H0081497 | MD | Yes |
Addresses
Primary practice location
220 Barton Blvd Unit C-14
Rockledge, FL 32955-2742
Mailing address
PO Box 1137
Melbourne, FL 32902-1137
Phone (321) 952-9696
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104270000 | Medicaid | MD | |
| 119778900 | Medicaid | FL |
Other providers in Rockledge, FL
- David Heinish
- Carolyn Helms
- Hematology Oncology Associates of Central Brevard
- Roger Henderson
- Atalaya Hammitt Hendrix
- Apolinar Adalberto Henriquez
- Kerri Henriquez
- Ashanti Henry
- Justine Henry
- Marisa Herman
All providers in Rockledge, FL · Internal Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.