NPIMap

Organization Active NPI

Beverly Radiology Medical Group

Doing business as Temecula Valley Imaging Center

  • Diagnostic Radiology Physician
  • Fallbrook, CA
National Provider Identifier
1043681752
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
BEVERLY RADIOLOGY MEDICAL GROUP
Doing business as
Temecula Valley Imaging Center
Practice address
521 E Elder St
Suite 101
Fallbrook, CA 92028-3081
Phone
(310) 445-2000
NPI assigned
Oct 8, 2015
Last updated
Oct 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

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

Authorized official

Name
Howard G. Berger, M.D.
Title
President & Ceo
Phone
(310) 445-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

521 E Elder St
Suite 101
Fallbrook, CA 92028-3081

Mailing address

521 E Elder St
Suite 101
Fallbrook, CA 92028-3081
Phone (310) 445-2000

Other names 1

  • Temecula Valley Imaging Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000784 CA Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 343 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1043681752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 E ELDER ST",
            "address_2": "SUITE 101",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283081",
            "telephone_number": "310-445-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E ELDER ST",
            "address_2": "SUITE 101",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283081",
            "telephone_number": "310-445-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY RADIOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "310-445-2000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Temecula Valley Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fallbrook, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.

Verify at the official NPI Registry.