NPIMap

Individual provider Active NPI

John C Ninos, MD

  • Family Medicine Physician
  • Palm Springs, CA
National Provider Identifier
1104885300
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G88658 Issued in CA
Practice address
4791 E Palm Canyon Dr
Suite 100
Palm Springs, CA 92264-5220
Phone
(760) 834-7930
Fax
(760) 834-7931
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD025659E PA
Family Medicine Physician 207Q00000X G88658 CA Primary

Addresses

Primary practice location

4791 E Palm Canyon Dr
Suite 100
Palm Springs, CA 92264-5220

Mailing address

4791 E Palm Canyon Dr
Suite 100
Palm Springs, CA 92264-5220
Phone (760) 834-7930

Other identifiers 3

IdentifierTypeStateIssuer
50055533OtherPACAPITOL BC
0018716640001OtherPAMEDICAID
1772699OtherPAHIGHMARK BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
88658CAMDPharmacist
G88658CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eisenhower Medical Center Past Accepting new patients
Lock Haven Medical Professionals, P.C. Past Accepting new patients
Lock Haven Medical Professionals PC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1104885300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4791 E PALM CANYON DR",
            "address_2": "SUITE 100",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922645220",
            "telephone_number": "760-834-7930",
            "fax_number": "760-834-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4791 E PALM CANYON DR",
            "address_2": "SUITE 100",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922645220",
            "telephone_number": "760-834-7930",
            "fax_number": "760-834-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NINOS",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD025659E",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G88658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITOL BC",
            "identifier": "50055533",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "0018716640001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS",
            "identifier": "1772699",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.