Tiffany Raye Henderson, FNP-C is a medicare enrolled "Family Medicine" in Baytown, Texas. Her current practice location is
4002 Garth Rd, Baytown, Texas. You can reach out to her office (for appointments etc.) via phone at
(832) 695-3478.
Tiffany Raye Henderson is licensed to practice in Texas (license number 913399) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1942802624.
Provider's Profile
Full Name | Tiffany Raye Henderson |
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Gender | Female |
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Speciality | Family Medicine |
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Location | 4002 Garth Rd, Baytown, Texas |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1942802624
- Provider Enumeration Date: 11/09/2020
- Last Update Date: 02/10/2023
Medicare PECOS Information:
- PECOS PAC ID: 2567866684
- Enrollment ID: I20210811000721
Medical Identifiers
Medical identifiers for Tiffany Raye Henderson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1942802624 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 1031064 (Texas) | Secondary |
207Q00000X | Family Medicine | 913399 (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Tiffany Raye Henderson allows following entities to bill medicare on her behalf.
Entity Name | Kelsey-seybold Medical Group, Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1013915255 PECOS PAC ID: 9739093527 Enrollment ID: O20031117000204 |
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Entity Name | Space City Pain Specialists |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1790739472 PECOS PAC ID: 8921067018 Enrollment ID: O20041005000744 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tiffany Raye Henderson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Tiffany Raye Henderson, FNP-C 11511 Shadow Creek Pkwy, Pearland, TX 77584-7298 Ph: (713) 442-0000 | Tiffany Raye Henderson, FNP-C 4002 Garth Rd, Baytown, TX 77521-3180 Ph: (832) 695-3478 |
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