JACOB RAY HENDERSON DO
NPI 1487232401
Internal Medicine - Nephrology in Jacksonville, FL

Q: 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.

Q: What is Jacob Henderson's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: 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 21 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.

Active since March 31, 2021PECOS EnrolledAccepts Medicare Assignment

4500 SAN PABLO RD S, JACKSONVILLE, FL 32224(904) 953-2000 Get Directions Write a Review

NPPES record last updated: October 21, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 24, 2024, Apr 1, 2021 (2 updates tracked since 2021).

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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

NPI1487232401

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameJACOB RAY HENDERSONCredential: DO

Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865

Mailing Address4500 San Pablo Rd SJacksonville, FL 32224-1865 · (904) 953-2000

Phone(904) 953-2000

Sole ProprietorNo

Medical School CMSUniversity Of Pikeville, Kentucky College Of Osteopathic MedGraduated 2021

Enumeration DateMarch 31, 2021

Last NPPES UpdateOctober 21, 20242 updates tracked since enumeration

NPPES CertifiedOctober 21, 2024

✔ NPI 1487232401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in FL · OS21003

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

4500 SAN PABLO RD S, Jacksonville, FL 32224

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Secondary Practice Location 1

Location 12123 Auburn Ave Ste 235Cincinnati, OH 45219-2906 · Phone (513) 585-3238

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).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

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.

PECOS PAC ID7416356514

PECOS Enrollment IDI20240604001443

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 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.

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.

40 services37 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

18 services18 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

14 services14 patients

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, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100151

Location4500 San Pablo RdJacksonville, FL 32224 · Duval County

Emergency services

Physician 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.

New Patient

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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.

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.

KATHERINE L WALSH PA-C/MPH

Physician Assistant