Dr Madahari Tyler Aldhem Henry, MD in Elizabeth City, NC - Medicare Student in an Organized Health Care Education/Training Program

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.

Contact Information

	Dr Madahari Tyler Aldhem Henry, MD
	905 Thunder Rd Ste 140, Elizabeth City, NC 27909-7672
	(252) 334-0320
	(855) 330-7320

Map and Direction

Physician's Profile

Full Name	Dr Madahari Tyler Aldhem Henry
Gender	Male
Speciality	Student In An Organized Health Care Education/training Program
Location	905 Thunder Rd Ste 140, Elizabeth City, North Carolina
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
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942443130 PECOS PAC ID: 8729139852 Enrollment ID: O20090630000446

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

Dr Madahari Tyler Aldhem Henry, MD - Medicare Student in an Organized Health Care Education/Training Program in Elizabeth City, NC