SEAN HENLEY MD
NPI 1366000424
Family Medicine in Tucson, AZ

Active since June 04, 2019PECOS EnrolledAccepts Medicare Assignment
97.64/100
CMS Quality Rating
707 N ALVERNON WAY, TUCSON, AZ 85711(520) 694-8888 Get Directions Write a Review

NPPES record last updated: August 2, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sean Henley Md NPPES

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

SEAN HENLEY MD (NPI 1366000424) is an individual family medicine provider in Tucson, Arizona, licensed in Arizona (65972) and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS and is a graduate of University Of North Dakota School Of Medicine (2019).

NPPES Registry Identity

NPI1366000424
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameSEAN HENLEYCredential: MD
Location Address707 N ALVERNON WAYTucson, AZ 85711-1827
Mailing Address707 N Alvernon WayTucson, AZ 85711-1827 · (520) 694-8888
Sole ProprietorNo
Medical School CMSUniversity Of North Dakota School Of MedicineGraduated 2019
Enumeration DateJune 4, 2019
Last NPPES UpdateAugust 2, 2023
NPPES CertifiedAugust 23, 2022
NPI 1366000424 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in AZ · 65972
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
707 N ALVERNON WAY, Tucson, AZ 85711

Accepted 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

Sean Henley Md 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 ID7214266816
PECOS Enrollment IDI20220621000884
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 7

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.

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.
69 services59 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
64 services58 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
41 services19 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
27 services12 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
21 services21 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85711 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
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
Most-billed visit code 99214
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.

97.64/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality84.77
Promoting Interoperability98.67
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$17.89 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier11 claims11 services$91.51 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Nurse Practitioner (Family)
707 N ALVERNON WAY, STE. 101
TUCSON, AZ 85711
Ophthalmology (Pediatric Ophthalmology and Strabismus Specialist)
707 N ALVERNON WAY
TUCSON, AZ 85711
Counselor (Addiction (Substance Use Disorder))
707 N ALVERNON WAY
TUCSON, AZ 85711
Ophthalmology
707 N ALVERNON WAY
TUCSON, AZ 85711
Family Medicine
707 N ALVERNON WAY
TUCSON, AZ 85711
Orthopaedic Surgery
707 N ALVERNON WAY, ORTHOPAEDIC SURGERY - SUITE 205
TUCSON, AZ 85711
Pharmacist
707 N ALVERNON WAY
TUCSON, AZ 85711
Family Medicine
707 N ALVERNON WAY
TUCSON, AZ 85711

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 Sean Henley's NPI number?

The NPI number for Sean Henley is 1366000424. It was assigned to this individual provider in the NPPES registry on June 4, 2019.

Where is Sean Henley located?

Sean Henley practices at 707 N Alvernon Way, Tucson, AZ 85711. The listed phone number is (520) 694-8888.

What is Sean Henley's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sean Henley enrolled in Medicare?

Yes. Sean Henley 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.

What insurance does Sean Henley accept?

Health plans from Ambetter from Arizona Complete Health, Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc. and Oscar Health Plan, Inc. and 1 other insurer list Sean Henley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sean Henley was last updated on August 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.