Individual provider Active NPI

Waldo N. Henriquez, MD

  • Pediatrics Physician
  • Visalia, CA
National Provider Identifier
1962561076
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A95061 Issued in CA
Practice address
501 North Bridge Street
Visalia, CA 93291-5014
Phone
(559) 734-1939
Fax
(559) 734-4384
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A95061 CA Primary

Addresses

Primary practice location

501 North Bridge Street
Visalia, CA 93291-5014

Mailing address

305 East Center Ave.
Visalia, CA 93291-6331
Phone (559) 737-4700

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
I20071217000211 CA Practitioner - Pediatric Medicine 5890885743 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A95061CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network CurrentSince May 6, 2016 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network CurrentSince May 6, 2016 Accepting new patients
Family Healthcare Network Current Accepting new patients
Kaweah Delta Health Care District Past Accepting new patients
Family Healthcare Network Past Accepting new patients

Locations

33025 Road 159
Ivanhoe, CA 93235
Phone (559) 798-1877

12586 Avenue 408
Orosi, CA 93647
Phone (559) 528-2804

41651 Sierra Dr
#A
Three Rivers, CA 93271
Phone (559) 561-4683

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

501 N Bridge St
Visalia, CA 93291
Phone (559) 734-1939

31180 Road 72
Visalia, CA 93291
Phone (559) 651-2301

401 E School Ave
Visalia, CA 93291
Phone (559) 741-4356

400 E Oak Ave
Visalia, CA 93291
Phone (559) 741-4500

201 E Lakeview Ave
Woodlake, CA 93286
Phone (559) 564-0100

Interoperability endpoints

  • Direct secure messaging: waldo.henriquez@fhcn.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CCECCA

Organizations & group practices 10

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375142400000",
    "number": "1962561076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 EAST CENTER AVE.",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916331",
            "telephone_number": "559-737-4700",
            "fax_number": "559-737-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 NORTH BRIDGE STREET",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915014",
            "telephone_number": "559-734-1939",
            "fax_number": "559-734-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIQUEZ",
        "first_name": "WALDO",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2013-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A95061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.