NPIMap

Organization Active NPI

Dr. Javier Rios, a Medical Corporation

Doing business as Lake Elsinore Clinica Medica Familiar

  • Family Medicine Physician
  • Lake Elsinore, CA
National Provider Identifier
1033418785
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A53521 Issued in CA
Legal business name
DR. JAVIER RIOS, A MEDICAL CORPORATION
Doing business as
Lake Elsinore Clinica Medica Familiar
Practice address
141 N Main St
Lake Elsinore, CA 92530-4118
Phone
(855) 505-7467
Fax
(888) 975-8926
NPI assigned
Mar 21, 2011
Last updated
Jun 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Authorized official

Name
Javier R Rios, MDNPI 1639246176
Title
Ceo
Phone
(951) 354-3221

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A53521 CA Primary
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

141 N Main St
Lake Elsinore, CA 92530-4118

Mailing address

495 E Rincon St Ste 215
Corona, CA 92879-1378
Phone (951) 523-0117

Other names 1

  • Lake Elsinore Clinica Medica Familiar Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150107002576 CA Part B Supplier - Clinic/Group Practice 4183892508 Receives reassigned benefits from 32 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Temecula, CA; Perris, CA; Morongo Valley, CA; Lake Elsinore, CA; Indio, CA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2029395Lake Elsinore Clinica Medica Familiar141 N Main St, Lake Elsinore, CA 92530Certificate of waiverSep 6, 2027

National Provider Directory

National Provider Directory

Locations

495 E Rincon St
Ste 215
Corona, CA 92879

82935 Avenue 48
Ste 101
Indio, CA 92201

49867 29 Palms Hwy
Morongo Valley, CA 92256

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654473600000",
    "number": "1033418785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 E RINCON ST STE 215",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791378",
            "telephone_number": "951-523-0117",
            "fax_number": "951-394-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N MAIN ST",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304118",
            "telephone_number": "855-505-7467",
            "fax_number": "888-975-8926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JAVIER RIOS, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-21",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "RIOS",
        "authorized_official_first_name": "JAVIER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-354-3221",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A53521",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Elsinore Clinica Medica Familiar",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Elsinore Clinica Medica Familiar",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.