Mrs Tari Renee Henderson, AGNP-C - Medicare Nurse Practitioner in Cleveland, OH

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Mrs Tari Renee Henderson, AGNP-C is a medicare enrolled "Nurse Practitioner - Gerontology" in Cleveland, Ohio. She graduated from nursing school in 2016 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Southwest General Health Center and her current practice location is 11100 Euclid Ave, Medicine/cardiology Learner 3, Cleveland, Ohio. You can reach out to her office (for appointments etc.) via phone at (216) 983-4900.

Mrs Tari Renee Henderson is licensed to practice in Ohio (license number CNP-020426) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1912442179.

Contact Information

Mrs Tari Renee Henderson, AGNP-C
11100 Euclid Ave, Medicine/cardiology Learner 3,
Cleveland, OH 44106-1716
(216) 983-4900
Not Available

Map and Direction




Provider's Profile

Full NameMrs Tari Renee Henderson
GenderFemale
SpecialityNurse Practitioner
Experience9 Years
Location11100 Euclid Ave, Cleveland, Ohio
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mrs Tari Renee Henderson graduated from nursing school in 2016
  NPI Data:
  • NPI Number: 1912442179
  • Provider Enumeration Date: 12/27/2016
  • Last Update Date: 12/21/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 2769767342
  • Enrollment ID: I20170322000867

Medical Identifiers

Medical identifiers for Mrs Tari Renee Henderson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1912442179NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2200XNurse Practitioner - Adult Health AG1116006 (Ohio)Secondary
363LG0600XNurse Practitioner - Gerontology AG111006 (Ohio)Secondary
363LP2300XNurse Practitioner - Primary Care AG1116006 (Ohio)Secondary
363LG0600XNurse Practitioner - Gerontology CNP-020426 (Ohio)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Southwest General Health CenterMiddleburg heights, OHHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Southwest General Health Center701290924526

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. Mrs Tari Renee Henderson allows following entities to bill medicare on her behalf.
Entity NameSouthwest General Health Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1740608306
PECOS PAC ID: 7012909245
Enrollment ID: O20040330001464
Entity NameEmh Regional Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1841299039
PECOS PAC ID: 7517931389
Enrollment ID: O20040826000069
Entity NameUniversity Hospitals Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669499414
PECOS PAC ID: 4789682493
Enrollment ID: O20061113000301
Entity NameTraveling Nurse Practitioner, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1588995849
PECOS PAC ID: 7012040421
Enrollment ID: O20100805000910

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. Mrs Tari Renee 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
Mrs Tari Renee Henderson, AGNP-C
11100 Euclid Ave, Medicine/cardioligy Learner 3,
Cleveland, OH 44106-1716

Ph: (216) 983-4900		Mrs Tari Renee Henderson, AGNP-C
11100 Euclid Ave, Medicine/cardiology Learner 3,
Cleveland, OH 44106-1716

Ph: (216) 983-4900

Reviews and Comments


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Kristin R Johnson, CNP
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Ms. Dana Anne Rubis, CNP
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Denise Louise Page, NP-C
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Mrs. Maureen Patrice Mcgoff Allen, BSN-RN, MSN-FNP
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Phone: 216-444-5329    Fax: 216-445-1521
Anne M Tomsich, CNP
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Practice Location: 9500 Euclid Ave, Q10-1, Cleveland, OH 44195
Phone: 216-444-0415    Fax: 216-445-2267
Mrs. Allison Leigh Pullum, CNP
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Medicare: Accepting Medicare Assignments
Practice Location: 9500 Euclid Ave, C25, Cleveland, OH 44195
Phone: 216-445-1583    Fax: 216-444-9890

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.