DR. JUSTINE ELODIA HENAO D.O.
NPI 1902808645
Internal Medicine in Cumming, GA

Active since August 12, 2005PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1200 NORTHSIDE FORSYTH DR, CUMMING, GA 30041(770) 844-3200(404) 851-6325 Get Directions Write a Review

NPPES record last updated: August 31, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 31, 2023, Jan 19, 2017 (2 updates tracked since 2017).

About Dr. Justine Elodia Henao D.o. NPPES

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

DR. JUSTINE ELODIA HENAO D.O. (NPI 1902808645) is an individual internal medicine provider in Cumming, Georgia, licensed in Texas (U5861) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS, is affiliated with Hillsboro Area Hospital, and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2001).

NPPES Registry Identity

NPI1902808645
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. JUSTINE ELODIA HENAOCredential: D.O.
Location Address1200 NORTHSIDE FORSYTH DRCumming, GA 30041-7659
Mailing Address1200 Northside Forsyth DrCumming, GA 30041-7659 · (770) 844-3200 · Fax (404) 851-6325
Fax(404) 851-6325
Sole ProprietorNo
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2001
Enumeration DateAugust 12, 2005
Last NPPES UpdateAugust 31, 20232 updates tracked since enumeration
NPPES CertifiedAugust 31, 2023
NPI 1902808645 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses Licensed in TX · U5861 Licensed in GA · 052580
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedHospitalistTaxonomy 208M00000X · License 052580 (GA)
1200 NORTHSIDE FORSYTH DR, Cumming, GA 30041

Other Identifiers 2

Medicaid608048816AGA
Other52703489GA · Blue Cross Blue Shield

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

Dr. Justine Elodia Henao D.o. 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 ID2769458561
PECOS Enrollment IDI20211006000289, I20230915000386, I20231003000386, I20231023001478, I20231213001617, I20240125001235
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 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.

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.
75 services73 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.
54 services33 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.
34 services22 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
21 services20 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Hillsboro Area Hospital

Critical Access Hospitals · Hillsboro, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141332
Location1200 E Tremont StreetHillsboro, IL 62049 · Montgomery County
Emergency services

Ochsner American Legion Hospital

Acute Care Hospitals · Jennings, LA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190053
Location1634 Elton RoadJennings, LA 70546 · Jeffrson Davis County
Emergency services Birthing friendly

Holmes County Hospital And Clinics

Critical Access Hospitals · Lexington, MS
OwnershipGovernment - State
CMS Certification Number251319
Location239 Bowling Green RoadLexington, MS 39095 · Holmes County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30041 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 4

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 supplier13 claims13 services$12.57 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
2 suppliers21 claims21 services$60.07 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
3 suppliers22 claims22 services$21.70 avg. paid by Medicare
Elevating leg rests, pair (for use with capped rental wheelchair base) K0195
DME-Wheelchairs · category DD021N
2 suppliers21 claims21 services$9.02 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.

Pharmacist
1200 NORTHSIDE FORSYTH DR
CUMMING, GA 30041
Pharmacist
1200 NORTHSIDE FORSYTH DR
CUMMING, GA 30041
Dietitian, Registered
1200 NORTHSIDE FORSYTH DR
CUMMING, GA 30041
Pharmacist
1200 NORTHSIDE FORSYTH DR
CUMMING, GA 30041
Internal Medicine (Cardiovascular Disease)
1200 NORTHSIDE FORSYTH DR
CUMMING, GA 30041
Internal Medicine
1200 NORTHSIDE FORSYTH DR
CUMMING, GA 30041
Hospitalist
1200 NORTHSIDE FORSYTH DR
CUMMING, GA 30041
Pharmacist
1200 NORTHSIDE FORSYTH DR
CUMMING, GA 30041

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 Justine Henao's NPI number?

The NPI number for Justine Henao is 1902808645. It was assigned to this individual provider in the NPPES registry on August 12, 2005.

Where is Justine Henao located?

Justine Henao practices at 1200 Northside Forsyth Dr, Cumming, GA 30041. The listed phone number is (770) 844-3200.

What is Justine Henao's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Justine Henao enrolled in Medicare?

Yes. Justine Henao 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 Justine Henao accept?

Health plans from Arkansas Blue Cross and Blue Shield, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan and HMO Louisiana and 2 other insurers list Justine Henao 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 Justine Henao affiliated with any hospitals?

According to CMS data, Justine Henao is affiliated with Hillsboro Area Hospital, Ochsner American Legion Hospital and Holmes County Hospital And Clinics.

When was this NPI record last updated?

The NPPES record for Justine Henao was last updated on August 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.