Physician Compare National (NPI:1851463228)

HEALTHCARE PROVIDER: REUBEN S HENDERSON DO

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1851463228
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0345234571
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040412000926
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HENDERSON
	Individual professional last name
Provider First Name	REUBEN
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DO
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	1994
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PAIN MANAGEMENT
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PAIN MANAGEMENT
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	3937 PATIENT CARE DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 107
	Group Practice or individual's line 2 address
City	LANSING
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	489114287
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	230230
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	EDWARD W SPARROW HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230167
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MCLAREN GREATER LANSING
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y