JACQUELYNN DIAN HENDERSON PA-C
NPI 1003875253
Physician Assistant in Phoenix, AZ

Q: What is Jacquelynn Henderson's NPI number?

The NPI number for Jacquelynn Henderson is 1003875253. It was assigned to this individual provider in the NPPES registry on March 17, 2006.

Q: What is Jacquelynn Henderson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since March 17, 2006PECOS EnrolledAccepts Medicare Assignment

84.13/100

CMS Quality Rating

4800 N 22ND ST, PHOENIX, AZ 85016(602) 955-1000(602) 508-4830 Get Directions Write a Review

NPPES record last updated: January 11, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jacquelynn Dian Henderson Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELYNN DIAN HENDERSON PA-C (NPI 1003875253) is an individual physician assistant in Phoenix, Arizona, licensed in Arizona (5994) and active in the NPI registry since March 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1996).

NPPES Registry Identity

NPI1003875253

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameJACQUELYNN DIAN HENDERSONCredential: PA-C

Location Address4800 N 22ND STPhoenix, AZ 85016-4701

Mailing Address4800 N 22nd StPhoenix, AZ 85016-4701 · (602) 955-1000 · Fax (602) 508-4830

Phone(602) 955-1000

Fax(602) 508-4830

Sole ProprietorNo

Medical School CMSOtherGraduated 1996

Enumeration DateMarch 17, 2006

Last NPPES UpdateJanuary 11, 2016

✔ NPI 1003875253 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in AZ · 5994✔ Licensed in CA · PA13970

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

4800 N 22ND ST, Phoenix, AZ 85016

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Other Identifiers 1

OtherZ181353AZ · Medicare Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc., UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacquelynn Dian Henderson Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103057575

PECOS Enrollment IDI20151009001475

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

343 services343 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

64 services63 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85016 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$69.24 typical visit price

range $17.72 – $137.41

Typical copayment $17.31 (range $4.43 – $34.35)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.13/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

93.93

Promoting Interoperability

100

Improvement Activities

Cost

53.19

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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