RICHARD L. HENDERSON (MD) – Family Medicine Physician, NPI 1063589943

RICHARD L. HENDERSON (MD) is a healthcare provider. based in Fontana, California. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. A46600 (CA). The NPI Number for RICHARD L. HENDERSON (MD) is 1063589943

Main info

Male
46 Years Of Experience
Accepts Medicare Assignment
Name
RICHARD L. HENDERSON (MD)
NPI
1063589943
Phone
(909) 427-3910
Address
9961 Sierra Ave
Enumeration Date
29 November 2006
Last Update Date
17 March 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7603184730
Graduation Year
1980 (46 years ago)
PAC ID
3779654777
Group Practice PAC ID
0941465322
Professional Enrollment ID
I20080618000824
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for RICHARD L. HENDERSON (MD)

  • 9961 Sierra Ave

    Fontana, CA 923356720

    Phone: (909) 427-3910

    Type: Location

  • 555 E TACHEVAH DR STE 2E107

    PALM SPRINGS, CA 922625752

    Phone: (760) 561-7373

    Fax: (760) 327-5140

    Type: Mailing

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: 2008-06-18

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080618000824IFamily PracticeCATBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes10192$0
View full utilization report →

Insurance plans in this area (ZIP 92335)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941465322View full group profile
NameSpecialtyState
Internal MedicineCA
-CA
G A S T R O E N T E R O L O G YCA
Internal Medicine, Critical Care (Intensivists), Pulmonary Disease, Pulmonary DiseaseMD
O P T O M E T R YCA
-CA
O P T O M E T R YCA
O B S T E T R I C S/ G Y N E C O L O G YKY
Orthopedic SurgeryCA
Pulmonary Disease, Internal MedicineUT

Reviews

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Frequently asked questions

How do payers reference RICHARD L. HENDERSON (MD)?
For RICHARD L. HENDERSON (MD), use NPI 1063589943 as the unique 10-digit identifier.
Is RICHARD L. HENDERSON (MD) shown as active in public data?
Registry records indicate RICHARD L. HENDERSON (MD) maintains an active NPI.
What kind of doctor is RICHARD L. HENDERSON (MD)?
RICHARD L. HENDERSON (MD) is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with RICHARD L. HENDERSON (MD)?
Directory geography for RICHARD L. HENDERSON (MD) centers on Fontana, California.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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