Individual provider Active NPI

Brandon Garret Louie, M.D.

  • Urology Physician
  • Riverside, CA
National Provider Identifier
1104152149
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A109692 Issued in CA
Practice address
4244 Riverwalk Pkwy Ste 240
Riverside, CA 92505-3372
Phone
(951) 509-3580
Fax
(951) 509-4552
NPI assigned
Oct 27, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A109692 CA Primary

Addresses

Primary practice location

4244 Riverwalk Pkwy Ste 240
Riverside, CA 92505-3372

Mailing address

4244 Riverwalk Pkwy Ste 240
Riverside, CA 92505-3372
Phone (951) 509-3580

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141023001663 CA Practitioner - Urology 5395966972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Georgetown University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology Center of Southern California Medical Group IncGroup PAC ID 6406745439, 7 clinicians

Practice addresses (Care Compare)

3975 Jackson St
Suite 308
Riverside, CA 92503-3951
Phone (951) 687-8730

Hospital & facility affiliations

  • Corona Regional Medical Center Hospital, Corona, CA, CCN 050329
  • Parkview Community Hospital Medical Center Hospital, Riverside, CA, CCN 050102

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A109692CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Center of So Calif Medical Group Inc Urology Current Accepting new patients
Urology Center of Southern California Medical Group Inc Urology CurrentSince Nov 1, 2023 Accepting new patients
Urology Center of Southern California Medical Group Inc Urology CurrentSince Nov 1, 2023 Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Uhs Corona Inc Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Doctors Hospital of Riverside LLC Past Accepting new patients

Locations

801 S Main St
Ste 201
Corona, CA 92882
Phone (951) 735-2700

28078 Baxter Rd
Ste 405
Murrieta, CA 92563

28078 Baxter Rd
Ste 450
Murrieta, CA 92563
Phone (951) 677-3000

3975 Jackson St
Ste 308
Riverside, CA 92503
Phone (951) 687-8730

4244 Riverwalk Pkwy
Ste 240
Riverside, CA 92505
Phone (951) 509-3580

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 2

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": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104152149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4244 RIVERWALK PKWY STE 240",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053372",
            "telephone_number": "951-509-3580",
            "fax_number": "951-509-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4244 RIVERWALK PKWY STE 240",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053372",
            "telephone_number": "951-509-3580",
            "fax_number": "951-509-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUIE",
        "first_name": "BRANDON",
        "middle_name": "GARRET",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A109692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.