Individual provider Active NPI

Maryann Raafat Henin, D.O.

  • Internal Medicine Physician
  • Rockledge, FL
National Provider Identifier
1841633765
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
H0081497 Issued in 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
Last updated
Oct 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X H0081497 MD Primary

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

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240607001675 FL Practitioner - Internal Medicine 9032413851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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 IncGroup PAC ID 0446201768, 50 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
H0081497MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Health Alliance Inc Current Accepting new patients
Brevard Health Alliance Inc CurrentSince Mar 19, 2024 Accepting new patients
Brevard Health Alliance, Inc. CurrentSince Mar 19, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Brevard Health Alliance Inc Past Accepting new patients

Locations

905 Pineda St
Cocoa, FL 32922

775 Malabar Rd
Malabar, FL 32950
Phone (321) 722-8435

17 Silver Palm Ave
Melbourne, FL 32901
Phone (321) 725-9041

2120 Sarno Rd
Melbourne, FL 32935
Phone (321) 952-9696

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

  • Direct secure messaging: maryann.henin@bha.eclinicaldirectplus.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1841633765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329021137",
            "telephone_number": "321-952-9696",
            "fax_number": "321-952-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 BARTON BLVD UNIT C-14",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552742",
            "telephone_number": "321-241-6800",
            "fax_number": "321-241-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENIN",
        "first_name": "MARYANN",
        "middle_name": "RAAFAT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "H0081497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

Verify at the official NPI Registry.