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KENYATTA HENDERSON
NPI 1407729163
Nurse Practitioner - Family in Chicago, IL

Active since September 27, 2025PECOS Enrolled
9950 S ARTESIAN AVE, CHICAGO, IL 60655(888) 523-8268 Get Directions Write a Review

NPPES record last updated: October 24, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Kenyatta Henderson NPPES

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

KENYATTA HENDERSON (NPI 1407729163) is an individual family provider in Chicago, Illinois, licensed in Illinois (209029766) and active in the NPI registry since September 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1407729163
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKENYATTA HENDERSON
Location Address9950 S ARTESIAN AVEChicago, IL 60655-1051
Mailing Address9950 S Artesian AveChicago, IL 60655-1051
Phone(888) 523-8268
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateSeptember 27, 2025
Last NPPES UpdateOctober 24, 2025
NPPES CertifiedSeptember 27, 2025
✔ NPI 1407729163 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209029766
9950 S ARTESIAN AVE, Chicago, IL 60655
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenyatta Henderson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2668943234
PECOS Enrollment IDI20260604001159
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.

Medicare Billing Reassignment

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

Signify Health Medical Associates, PLLC
787 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Illinois enrollment
  • 712 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

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 60655 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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.

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 Kenyatta Henderson's NPI number?

The NPI number for Kenyatta Henderson is 1407729163. It was assigned to this individual provider in the NPPES registry on September 27, 2025.

Where is Kenyatta Henderson located?

Kenyatta Henderson practices at 9950 S Artesian Ave, Chicago, IL 60655. The listed phone number is (888) 523-8268.

What is Kenyatta Henderson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kenyatta Henderson enrolled in Medicare?

Yes. Kenyatta Henderson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kenyatta Henderson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenyatta Henderson reassigns Medicare benefits to Signify Health Medical Associates, PLLC (Dallas, TX). 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 Kenyatta 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 Kenyatta Henderson was last updated on October 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.