JAMIE HENNIGAN (MD) – Surgery Physician, NPI 1699195024
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
523 GENERAL SURGERY in AL
Provider Addresses for JAMIE HENNIGAN (MD)
4881 SUGAR MAPLE DR
WRIGHT PATTERSON AFB, OH 454335529
Phone: (937) 257-9514
Type: Mailing
162.5 N BAYOU ST
UPPER B
MOBILE, AL 36603
Phone: (850) 238-5947
Type: Location
LANDSTUHL REGIONAL MEDICAL CENTER
UNIT 3310
APO, AE 090943100
Phone: (314) 590-8751
Type: Mailing
48TH MEDICAL GROUP BUILDING #932
APO, AE 09464
Phone: (309) 226-8086
Type: Mailing
8TH MEDICAL GROUP BUILDING #932
APO, AE 09464
Phone: (309) 226-8086
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2026-02-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20251027001681 | I | General Surgery | CO | TBD |
| I20260212003487 | I | General Surgery | ND | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 45433)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | AZ | |
| Nurse Practitioner | CO | |
| Certified Registered Nurse Anesthetist (Crna) | ND | |
| - | TX | |
| General Surgery | ND | |
| - | ND | |
| Diagnostic Radiology | MN | |
| Diagnostic Radiology | MN | |
| Diagnostic Radiology | MN |
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