JACOB RAY HENDERSON DO
NPI 1487232401
Internal Medicine - Nephrology in Jacksonville, FL
About Jacob Ray Henderson Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACOB RAY HENDERSON DO (NPI 1487232401) is an individual nephrology provider in Jacksonville, Florida, licensed in Florida (OS21003) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS, is affiliated with Mayo Clinic, and maintains a secondary practice location in Cincinnati.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
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
Jacob Ray 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
2Medicare enrollment records show Jacob Henderson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Jacksonville, FL 32224
- Reassigned Medicare billing, Florida enrollment
- 1,828 clinicians in this Medicare group
Cincinnati, OH 45219
- Reassigned Medicare billing, Kentucky and Ohio enrollments
- 44 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 3
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.
Mayo Clinic
Acute Care Hospitals · Jacksonville, FLPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 32224 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
JACKSONVILLE, FL 32224
JACKSONVILLE, FL 32224
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 Jacob Henderson's NPI number?
The NPI number for Jacob Henderson is 1487232401. It was assigned to this individual provider in the NPPES registry on March 31, 2021.
Where is Jacob Henderson located?
Jacob Henderson practices at 4500 San Pablo Rd S, Jacksonville, FL 32224. The listed phone number is (904) 953-2000.
What is Jacob Henderson's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.
Is Jacob Henderson enrolled in Medicare?
Yes. Jacob 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 Jacob Henderson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Henderson reassigns Medicare benefits to 2 organizations: Mayo Clinic Jacksonville (Jacksonville, FL) and Kidney And Hypertension Center Inc (Cincinnati, OH). 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 Jacob Henderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jacob Henderson accept?
Health plans from Anthem Blue Cross and Blue Shield, CareSource and Oscar Health Insurance list Jacob Henderson 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.
Is Jacob Henderson affiliated with any hospitals?
According to CMS data, Jacob Henderson is affiliated with Mayo Clinic.
When was this NPI record last updated?
The NPPES record for Jacob Henderson was last updated on October 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.
# Jacob Ray Henderson, DO · NPI 1487232401
Nephrology physician in Jacksonville, Florida. Individual provider, active in the CMS NPPES registry since March 31, 2021.
## Identity
- **NPI:** 1487232401 (Entity type: Individual)
- **Enumerated:** March 31, 2021
- **Primary specialty:** Internal Medicine - Nephrology · taxonomy 207RN0300X
- **State license:** OS21003 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 4500 SAN PABLO RD S, Jacksonville, FL 32224-1865
- **Phone:** (904) 953-2000
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Mayo Clinic Jacksonville (NPI 1174143986, Jacksonville, FL); Kidney And Hypertension Center Inc (NPI 1306944871, Cincinnati, OH) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** October 21, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1487232401) · Data from the CMS NPPES public registry.