NPIMap

Individual provider Active NPI

Jerald W Henry, MD

  • Diagnostic Radiology Physician
  • Grosse Pointe, MI
National Provider Identifier
1851359160
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301072837 Issued in MI
Practice address
468 Cadieux Road
Grosse Pointe, MI 48230
Phone
(313) 343-1630
Fax
(313) 343-1665
NPI assigned
May 3, 2006
Last updated
Oct 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301072837 MI Primary

Addresses

Primary practice location

468 Cadieux Road
Grosse Pointe, MI 48230

Mailing address

PO Box 1108
Attn:Barb Simmons
Ann Arbor, MI 48106-1108
Phone (313) 343-1630

Other identifiers 4

IdentifierTypeStateIssuer
P00063375OtherMIMEDICARE RR IND PIN
310H249790OtherMIBCBS GROUP PIN
CB6220OtherMIMEDICARE RR GROUP PIN
4536143MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jerald.Henry@beaumont.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040102000485 MI Practitioner - Diagnostic Radiology 2062311665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaumont Medical Group Hospital Based ServicesGroup PAC ID 3072875889, 575 clinicians

Practice addresses (Care Compare)

25631 Little Mack Ave
Saint Clair Shores, MI 48081-2100
Phone (586) 443-2998

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187

44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111

468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone (313) 473-1605

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
85.06
Promoting interoperability
100
Improvement activities
40
Cost
77.9

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group Hospital -Based Services CurrentSince May 15, 2018 Accepting new patients
Beaumont Special Radiological Procedures Diagnostic Radiology Past Accepting new patients
Macomb Magnetic Resonance Imaging Center Inc Diagnostic Radiology Past Accepting new patients

Locations

468 Cadieux Rd
Grosse Pointe Woods, MI 48230
Phone (313) 343-1000

3601 W 13 Mile Rd
Royal Oak, MI 48073

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Interoperability endpoints

  • Direct secure messaging: jerald.henry@beaumont.edu
  • Direct secure messaging: jhenry1237814@epic00.shdirect.org

Organizations & group practices 3

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 9

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1851359160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "address_2": "ATTN:BARB SIMMONS",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481061108",
            "telephone_number": "313-343-1630",
            "fax_number": "313-343-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 CADIEUX ROAD",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "48230",
            "telephone_number": "313-343-1630",
            "fax_number": "313-343-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "JERALD",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301072837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR IND PIN",
            "identifier": "P00063375",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PIN",
            "identifier": "310H249790",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR GROUP PIN",
            "identifier": "CB6220",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4536143",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jerald.Henry@beaumont.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "468 Cadieux Road",
            "city": "Grosse Pointe",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grosse Pointe, MI

Sources for this page

Verify at the official NPI Registry.