Jon Michael Henley, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10246T Issued in CA

Practice address

876 N Mountain Ave
Suite 100
Upland, CA 91786-4166

Phone

(909) 982-0900

Fax

(909) 982-7657

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Henley Optometric Corporation

  • Optometrist
  • Upland, CA
  • NPI 1710185459
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1619998192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "876 N MOUNTAIN AVE",
            "address_2": "SUITE 100",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864166",
            "telephone_number": "909-982-0900",
            "fax_number": "909-982-7657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "876 N MOUNTAIN AVE",
            "address_2": "SUITE 100",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864166",
            "telephone_number": "909-982-0900",
            "fax_number": "909-982-7657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENLEY",
        "first_name": "JON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10246T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helping Hands Hospice Care, Inc.
• Martha Henao, MD
• Charles Henderson, PA-C
• Henley Optometric Corporation
• Jason Henley
• Milagros Lizeth Henriquez
• Henry J Gonzalez M D Inc
• Kimberley Henry
• Kristina Henry, SLPA
• John Hephner

• Optometrist in Upland, CA
• Providers in Upland, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.