TARA DEDIC HENRIKSON (APN) – Adult Health Nurse Practitioner, NPI 1225386345
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for TARA DEDIC HENRIKSON (APN)
2160 SOUTH 1ST AVENUE
MAYOOWD, IL 60153
Phone: (708) 216-9000
Type: Mailing
250 E SUPERIOR ST STE 4-420
CHICAGO, IL 606112914
Phone: (312) 695-0990
Fax: (312) 472-4784
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $1,082.
Total Amount is formed as General ($1,082) + Research ($0) + Ownership ($0) = $1,082.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($927).
Total Amount
$1,082
General + Research + Ownership
Payments
7
Total payment records
General Amount
$1,082
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $927 |
| Seagen Inc. | $120 |
| Genentech USA, Inc. | $35 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2013-02-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130220000178 | I | Nurse Practitioner | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 30 | 28 | $0 |
Insurance plans in this area (ZIP 60153)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Diagnostic Radiology, Interventional Radiology | IL | |
| P A T H O L O G Y | IL | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | IL | |
| G A S T R O E N T E R O L O G Y | IL | |
| Internal Medicine | IL | |
| Cardiac Electrophysiology, Cardiovascular Disease (Cardiology), Internal Medicine | MN | |
| - | IL | |
| Physical Therapist In Private Practice | IL | |
| Nurse Practitioner | IL |
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