Dr Madahari Tyler Aldhem Henry, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Elizabeth City, North Carolina. His current practice location is
905 Thunder Rd Ste 140, Elizabeth City, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(252) 334-0320.
Dr Madahari Tyler Aldhem Henry is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1790356251.
Physician's Profile
Full Name | Dr Madahari Tyler Aldhem Henry |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 905 Thunder Rd Ste 140, Elizabeth City, North Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1790356251
- Provider Enumeration Date: 07/06/2021
- Last Update Date: 07/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 4183027246
- Enrollment ID: I20240729004619
Medical Identifiers
Medical identifiers for Dr Madahari Tyler Aldhem Henry such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1790356251 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 1790356251 (North Carolina) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Madahari Tyler Aldhem Henry allows following entities to bill medicare on his behalf.
Entity Name | Albemarle Physician Services - Sentara Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1942443130 PECOS PAC ID: 8729139852 Enrollment ID: O20090630000446 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Madahari Tyler Aldhem Henry is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Madahari Tyler Aldhem Henry, MD 1221 E State St, Rockford, IL 61104-2231 Ph: (815) 972-1000 | Dr Madahari Tyler Aldhem Henry, MD 905 Thunder Rd Ste 140, Elizabeth City, NC 27909-7672 Ph: (252) 334-0320 |
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