BREANNA HENDERSON
NPI 1073885711
Physical Therapist in Riverside, CA

Active since January 26, 2012Accepts Medicare Assignment
3865 JACKSON ST, RIVERSIDE, CA 92503(951) 688-2211 Get Directions Write a Review

NPPES record last updated: December 23, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Breanna Henderson NPPES

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

BREANNA HENDERSON (NPI 1073885711) is an individual physical therapist in Riverside, California, licensed in California (34068) and active in the NPI registry since January 2012. She is a graduate of Other (2007).

NPPES Registry Identity

NPI1073885711
Entity TypeIndividualFemale
Primary Taxonomy225100000X
Provider Legal NameBREANNA HENDERSON
Location Address3865 JACKSON STRiverside, CA 92503-3919
Mailing Address3865 Jackson StRiverside, CA 92503-3919 · (951) 688-2211
Sole ProprietorYes
Medical School CMSOtherGraduated 2007
Enumeration DateJanuary 26, 2012
Last NPPES UpdateDecember 23, 2021
NPPES CertifiedDecember 23, 2021
✔ NPI 1073885711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in CA · 34068
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
3865 JACKSON ST, Riverside, CA 92503

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Breanna Henderson 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 ID3072775303
PECOS Enrollment IDI20120503000319

Medicare Billing Reassignment

Medicare enrollment records show Breanna Henderson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Health Maintenance Organization
10800 MAGNOLIA AVE
Riverside, CA 92505
  • Reassigned Medicare billing, California enrollment
  • Also billed through NPI 1952333460 (California)
  • 5,228 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92503 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
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.

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.

Emergency Medicine
3865 JACKSON ST
RIVERSIDE, CA 92503
Radiology (Diagnostic Radiology)
3865 JACKSON ST
RIVERSIDE, CA 92503
Registered Nurse (Registered Nurse First Assistant)
3865 JACKSON ST
RIVERSIDE, CA 92503
Advanced Practice Midwife
3865 JACKSON ST
RIVERSIDE, CA 92503
Pediatrics (Neonatal-Perinatal Medicine)
3865 JACKSON ST
RIVERSIDE, CA 92503
General Acute Care Hospital
3865 JACKSON ST
RIVERSIDE, CA 92503
Emergency Medicine
3865 JACKSON ST
RIVERSIDE, CA 92503
Pharmacist
3865 JACKSON ST
RIVERSIDE, CA 92503

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Breanna Henderson's NPI number?

The NPI number for Breanna Henderson is 1073885711. It was assigned to this individual provider in the NPPES registry on January 26, 2012.

Where is Breanna Henderson located?

Breanna Henderson practices at 3865 Jackson St, Riverside, CA 92503. The listed phone number is (951) 688-2211.

What is Breanna Henderson's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Breanna Henderson enrolled in Medicare?

Yes. Breanna Henderson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Breanna Henderson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Breanna Henderson reassigns Medicare benefits to Southern California Permanente Medical Group (Riverside, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Breanna Henderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Breanna Henderson was last updated on December 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.