DR. JERRY PAUL HENDERSON DO
NPI 1245725977
Emergency Medicine in Wyoming, MI
About Dr. Jerry Paul Henderson Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JERRY PAUL HENDERSON DO (NPI 1245725977) is an individual emergency medicine provider in Wyoming, Michigan, licensed in Missouri (2021016736) and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS, is affiliated with Munson Healthcare Otsego Memorial Hospital, and is a graduate of West Virginia School Of Osteopathic Medicine (2018).
NPPES Registry Identity
Specialties & Licenses
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
Dr. Jerry Paul Henderson Do 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.
Medicare Billing Reassignments
3Medicare enrollment records show Jerry Henderson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Charlevoix, MI 49720
- Reassigned Medicare billing, Michigan enrollment
- 97 clinicians in this Medicare group
Kirksville, MO 63501
- Reassigned Medicare billing, Missouri enrollment
- 78 clinicians in this Medicare group
Osage Beach, MO 65065
- Reassigned Medicare billing, Missouri enrollment
- 77 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.
Areas of Expertise CMS Part B claims 4
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Munson Healthcare Otsego Memorial Hospital
Acute Care Hospitals · Gaylord, MIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49519 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
WYOMING, MI 49519
WYOMING, MI 49519
WYOMING, MI 49519
WYOMING, MI 49519
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 Jerry Henderson's NPI number?
The NPI number for Jerry Henderson is 1245725977. It was assigned to this individual provider in the NPPES registry on June 26, 2018.
Where is Jerry Henderson located?
Jerry Henderson practices at 5900 Byron Center Ave SW, Wyoming, MI 49519. The listed phone number is (616) 252-7604.
What is Jerry Henderson's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Jerry Henderson enrolled in Medicare?
Yes. Jerry 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 organizations bill Medicare for Jerry Henderson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jerry Henderson reassigns Medicare benefits to 3 organizations: Hawk Emergency Group, P.C. (Charlevoix, MI), Ripley Emergency Group, LLC (Kirksville, MO) and Camden Emergency Group LLC (Osage Beach, MO). Each 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 Jerry Henderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Jerry Henderson affiliated with any hospitals?
According to CMS data, Jerry Henderson is affiliated with Munson Healthcare Otsego Memorial Hospital.
When was this NPI record last updated?
The NPPES record for Jerry Henderson was last updated on July 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Dr. Jerry Paul Henderson, DO · NPI 1245725977
Emergency Medicine physician in Wyoming, Michigan. Individual provider, active in the CMS NPPES registry since June 26, 2018.
## Identity
- **NPI:** 1245725977 (Entity type: Individual)
- **Enumerated:** June 26, 2018
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 2021016736 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 5900 BYRON CENTER AVE SW, Wyoming, MI 49519-9606
- **Phone:** (616) 252-7604
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Hawk Emergency Group, P.C. (NPI 1073295135, Charlevoix, MI); Ripley Emergency Group, LLC (NPI 1720606023, Kirksville, MO); Camden Emergency Group LLC (NPI 1003181637, Osage Beach, MO) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** West Virginia School Of Osteopathic Medicine, class of 2018
## Record status
- **NPPES last updated:** July 28, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1245725977) · Data from the CMS NPPES public registry.