NICHOLLE A HENLEY (D.O.) – Family Medicine Physician, NPI 1013351444
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,194 FAMILY PRACTICE in CA
Provider Addresses for NICHOLLE A HENLEY (D.O.)
1770 N Orange Grove Ave Ste 101
Pomona, CA 917673027
Phone: (909) 469-9494
Fax: (909) 469-2120
Type: Location
3110 Chino Ave Ste 150B
Chino Hills, CA 917091295
Phone: (909) 630-7868
Fax: (909) 469-2109
Type: Location
2333 Foothill Blvd Ste C
LA Verne, CA 917503027
Phone: (909) 392-6511
Fax: (909) 469-2137
Type: Location
1601 MONTE VISTA AVE STE 190
CLAREMONT, CA 917116600
Phone: (909) 865-9977
Fax: (909) 469-2119
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: 2017-03-14
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 |
|---|---|---|---|---|
| I20170314000693 | I | Family Practice | CA | 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 91767)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | CA | |
| Family Practice, Geriatric Medicine | CA | |
| - | CA | |
| Family Practice, Hospice/Palliative Care | UT | |
| Family Practice, Sports Medicine | CA | |
| - | CA | |
| Family Practice, Geriatric Medicine | CA | |
| Family Practice | CA | |
| Family Practice | CA | |
| - | CA |
Reviews
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