Individual provider Active NPI

Anne F Henzel

  • Ophthalmology Physician
  • Portola Valley, CA
National Provider Identifier
1942355953
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G82266 Issued in CA
Practice address
4370 Alpine Rd
Suite 200
Portola Valley, CA 94028-7952
Phone
(650) 325-3937
Fax
(650) 850-4199
NPI assigned
Jan 23, 2007
Last updated
Dec 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G82266 CA Primary

Addresses

Primary practice location

4370 Alpine Rd
Suite 200
Portola Valley, CA 94028-7952

Mailing address

4370 Alpine Rd
Suite 200
Portola Valley, CA 94028-7952
Phone (650) 325-3937

Other identifiers 1

IdentifierTypeStateIssuer
00G822660MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20140919000061 CA Practitioner - Ophthalmology 5890914105 Reassigns benefits to 3 organizations
Practice locations: Portola Valley, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G82266CAMDOphthalmology Physician
82266CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo Current Accepting new patients
County of San Mateo CurrentSince Jun 1, 2016 Accepting new patients
County of San Mateo Current Accepting new patients
County of San Mateo CurrentSince Jun 1, 2016 Accepting new patients
County of San Mateo Current Accepting new patients
County of San Mateo CurrentSince Jun 1, 2016 Accepting new patients
County of San Mateo CurrentSince Aug 9, 2016 Accepting new patients

Locations

2710 Middlefield Rd
Redwood City, CA 94063
Phone (650) 364-6010

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1942355953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 ALPINE RD",
            "address_2": "SUITE 200",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287952",
            "telephone_number": "650-325-3937",
            "fax_number": "650-850-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 ALPINE RD",
            "address_2": "SUITE 200",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287952",
            "telephone_number": "650-325-3937",
            "fax_number": "650-850-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENZEL",
        "first_name": "ANNE",
        "middle_name": "F",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G82266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G822660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portola Valley, CA

Sources for this page

Verify at the official NPI Registry.