Active NPI
Faculty Physicians and Surgeons of Llusm
- Ophthalmology Physician
- Riverside, CA
National Provider Identifier
1023206307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- FACULTY PHYSICIANS AND SURGEONS OF LLUSM
- Practice address
- 6377 Riverside Ave
Ste. 170
Riverside, CA 92506-3124 - Phone
- (909) 558-2154
- NPI assigned
- Oct 11, 2007
- Last updated
- May 18, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ricardo Peverini, M.D.
- Title
- President
- Phone
- (909) 558-7448
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | Primary |
Addresses
Primary practice location
6377 Riverside Ave
Ste. 170
Riverside, CA 92506-3124
Mailing address
File Number 54701
Los Angeles, CA 90074-0001
Phone (909) 558-3111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031211000981 | CA | Part B Supplier - Clinic/Group Practice | 1153227814 |
Receives reassigned benefits from 2,632 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
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- Loma Linda, CA
- NPI 1275556748
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192060800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1242604800000",
"number": "1023206307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FILE NUMBER 54701",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900740001",
"telephone_number": "909-558-3111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6377 RIVERSIDE AVE",
"address_2": "STE. 170",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925063124",
"telephone_number": "909-558-2154"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FACULTY PHYSICIANS AND SURGEONS OF LLUSM",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-11",
"last_updated": "2009-05-18",
"status": "A",
"authorized_official_last_name": "PEVERINI",
"authorized_official_first_name": "RICARDO",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "909-558-7448",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Riverside, CA
- F & B Healthcare (Extended Care Hospital of Riverside)
- Marquita Facen
- Riley Facer
- Faculty Medical Group of Llusm
- Faculty Physicians and Surgeons of Llusm
- Faculty Physicians and Surgeons of Llusm
- Faculty Physicians and Surgeons of Llusm
- Faculty Physicians and Surgeons of Llusm
- Faculty Physicians and Surgeons of Llusm
- Faculty Physicians and Surgeons of Llusm
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.