Individual provider Active NPI

Richard Pessagno, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Rancho Mirage, CA
National Provider Identifier
1043301377
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95012286 Issued in CA
Practice address
39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone
(760) 837-8767
Fax
(760) 837-8806
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95012286 CA Primary
Registered Nurse 163W00000X 26NR10203700 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NC10203700 NJ

Addresses

Primary practice location

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221

Mailing address

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 837-8767

Other identifiers 1

IdentifierTypeStateIssuer
8730601MedicaidNJ

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210119002523 CA Practitioner - Nurse Practitioner 0941239131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eisenhower Medical CenterGroup PAC ID 5890689657, 462 clinicians

Practice addresses (Care Compare)

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 340-3911

Hospital & facility affiliations

  • Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
85.37
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NR10203700NJMDRegistered Nurse
95012286CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eisenhower Medical Center Current Accepting new patients
Ehab Yacoub MD Inc. CurrentSince Mar 2, 2021 Accepting new patients
Eisenhower Medical Center CurrentSince Jan 18, 2021 Accepting new patients
Eisenhower Medical Center CurrentSince Jan 18, 2021 Accepting new patients
Vericare Behavioral Health of New Jersey, P.a. Psychiatric/Mental Health Past Accepting new patients
Stable Community Services Past Accepting new patients
Serenity Health Group, LLC Past Accepting new patients

Locations

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

39000 Bob Hope Dr
Ofc
Rancho Mirage, CA 92270
Phone (760) 333-1813

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

39950 Vista del Sol
Rancho Mirage, CA 92270
Phone (760) 340-0053

72201 Country Club Dr
Rancho Mirage, CA 92270
Phone (760) 340-5999

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1043301377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-837-8767",
            "fax_number": "760-837-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-837-8767",
            "fax_number": "760-837-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESSAGNO",
        "first_name": "RICHARD",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95012286",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR10203700",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NC10203700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8730601",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.