Individual provider Active NPI

Mary Catherine Henderson, P.T.

  • Physical Therapist
  • Anaheim, CA
National Provider Identifier
1891991394
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
28234 Issued in CA
Practice address
441 N Lakeview Ave
Anaheim, CA 92807-3028
Phone
(714) 279-4450
NPI assigned
Jun 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 28234 CA Primary

Addresses

Primary practice location

441 N Lakeview Ave
Anaheim, CA 92807-3028

Mailing address

21436 Coralita
Lake Forest, CA 92630-8202
Phone (949) 768-9677

Other names 1

  • Cathie Henderson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100712000121 CA Practitioner - Physical Therapist in Private Practice 6305978370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Restorative Therapy AssociatesGroup PAC ID 3072782705, 7 clinicians

Practice addresses (Care Compare)

101 Pacifica
Suite 270
Irvine, CA 92618-7338
Phone (949) 333-3833

23601 Moulton Pkwy
Suite 221
Laguna Hills, CA 92653-1979
Phone (949) 528-6287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Restorative Therapy Associates Physical Therapist CurrentSince Jul 28, 2022 Accepting new patients

Locations

15775 Laguna Canyon Rd
Ste 110
Irvine, CA 92618
Phone (714) 500-8388

101 Pacifica
Ste 270
Irvine, CA 92618
Phone (949) 333-3833

23521 Paseo de Valencia
Ste 110
Laguna Hills, CA 92653
Phone (949) 333-3833

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891991394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21436 CORALITA",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308202",
            "telephone_number": "949-768-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 N LAKEVIEW AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928073028",
            "telephone_number": "714-279-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "28234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHIE",
            "last_name": "HENDERSON",
            "credential": "P.T.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.