Justin Henderson, NP - Medicare Nurse Practitioner in Ponderay, ID

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Justin Henderson, NP is a medicare enrolled "Nurse Practitioner - Family" in Ponderay, Idaho. He graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Kootenai Urgent Care Llc and his current practice location is 30544 Id-200, #101, Ponderay, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 263-6300.

Justin Henderson is licensed to practice in Utah (license number 9132375-4405) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1770112138.

Contact Information

Justin Henderson, NP
30544 Id-200, #101,
Ponderay, ID 83852
(208) 263-6300
Not Available

Map and Direction




Provider's Profile

Full NameJustin Henderson
GenderMale
SpecialityNurse Practitioner
Experience5 Years
Location30544 Id-200, Ponderay, Idaho
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Justin Henderson graduated from nursing school in 2019
  NPI Data:
  • NPI Number: 1770112138
  • Provider Enumeration Date: 04/07/2020
  • Last Update Date: 04/06/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 8820410673
  • Enrollment ID: I20210722002308

Medical Identifiers

Medical identifiers for Justin Henderson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1770112138NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 9132375-4405 (Utah)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Kootenai HealthCoeur d'alene, IDHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Kootenai Urgent Care Llc105244194617

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. Justin Henderson allows following entities to bill medicare on his behalf.
Entity NameMichael R Dibenedetto Md Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083809727
PECOS PAC ID: 0840385670
Enrollment ID: O20071009000187
Entity NameKootenai Urgent Care Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1821312356
PECOS PAC ID: 1052441946
Enrollment ID: O20100621000358

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. Justin Henderson 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 AddressPractice Location Address
Justin Henderson, NP
700 W Ironwood Dr Ste 120e,
Coeur D Alene, ID 83814-2656

Ph: (208) 625-3640		Justin Henderson, NP
30544 Id-200, #101,
Ponderay, ID 83852

Ph: (208) 263-6300

Reviews and Comments


Nurse Practitioner Nurses in Ponderay, ID

Katrina Ann Cavanaugh, APRN-CNP, RN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 188 Birch Ave, Ponderay, ID 83852
Phone: 208-597-2508    
Kathy Gavin, FNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 30410 Highway 200, Ponderay, ID 83852
Phone: 208-263-1345    Fax: 208-255-5531
Graham Charles Andrews,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 400 Schweitzer Plaza Dr Ste 1, Ponderay, ID 83852
Phone: 208-263-0649    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.