Individual provider Active NPI

Nadine Darlene Henley, M.D.

  • Dermatology Physician
  • San Diego, CA
National Provider Identifier
1407097942
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A159592 Issued in CA
Practice address
6605 Nancy Ridge Dr
San Diego, CA 92121-2253
Phone
(858) 900-2747
NPI assigned
Mar 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X A159592 CA Primary

Addresses

Primary practice location

6605 Nancy Ridge Dr
San Diego, CA 92121-2253

Mailing address

6605 Nancy Ridge Dr
San Diego, CA 92121-2253

Other names 1

  • Nadine Henley Ruth Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221103000861 CA Practitioner - Dermatology 4385011337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Washington School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

300 Fir St
San Diego, CA 92101-2327
Phone (848) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision16
Removal of skin lesions505
Removal of nail tissue1-10
Removal or shaving of skin growth13
Skin biopsy150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A159592CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Dec 11, 2023 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Single Specialty CurrentSince Dec 11, 2023 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

300 Fir St
San Diego, CA 92101
Phone (619) 446-1586

Interoperability endpoints

  • Direct secure messaging: nhenley119167@sharphealthcare.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1407097942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6605 NANCY RIDGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6605 NANCY RIDGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212253",
            "telephone_number": "858-900-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENLEY",
        "first_name": "NADINE",
        "middle_name": "DARLENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-12",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A159592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NADINE",
            "last_name": "RUTH",
            "middle_name": "HENLEY",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.