Beverly Radiology Medical Group III

Organization Active NPI Diagnostic Radiology Physician · Victorville, CA

NPI 1114112372 · NPPES record last updated Oct 13, 2015

Key facts

NPI
1114112372
Entity type
Organization (NPI type 2)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
Legal business name
BEVERLY RADIOLOGY MEDICAL GROUP III
Practice address
17260 Bear Valley Rd
Suite 109
Victorville, CA 92395-7777
Phone
(310) 445-2851
Fax
(310) 479-1459
NPI assigned
Sep 11, 2007
Organization subpart
No

Authorized official

Name
Dr. Howard G. Berger, M.D.
Title
President
Phone
(310) 445-2851

Other NPIs on the same Medicare enrollment 15

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

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 381

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 381

Medicare participation

Medicare fee-for-service enrollment
Enrolled (35 enrollments) in CA, AZ, PA, IL, CO, TX, VA, HI, DC, DE, NJ, GA, MD, NY, FL, SC, WA, OR, LA, KS, NC, WI, ME, MI, OH, TN, ID, NV, KY, CT, NE, IA, IN

Medicare enrollment records

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
O20040202001145 CA Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 330 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20060221000914 CA Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 366 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clovis, CA; Blackhawk, CA; Wildomar, CA; Temecula, CA; Sunnyvale, CA; San Jacinto, CA; Riverside, CA; Redwood City, CA…
O20141029002601 AZ Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 22 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Scottsdale, AZ; Tempe, AZ; Cave Creek, AZ; Chandler, AZ; Flagstaff, AZ; Gilbert, AZ; Paradise Valley, AZ…
O20150828001730 PA Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 2 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ardmore, PA; Haverford, PA
O20150908000430 IL Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 5 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vernon Hills, IL; Chicago, IL; Libertyville, IL; Oak Brook, IL
O20150909000429 CO Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 2 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Littleton, CO; Grand Junction, CO; Edwards, CO; Denver, CO; Colorado Springs, CO; Castle Pines, CO
O20150917001294 TX Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 18 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Houston, TX; McKinney, TX; San Antonio, TX; Fair Oaks Ranch, TX; Spicewood, TX; Spring, TX; Whitehouse, TX; Aledo, TX…
O20150921000673 VA Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 1 practitioner
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glen Allen, VA; Midlothian, VA
O20150925001097 HI Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 2 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Honolulu, HI; Kihei, HI; Kamuela, HI
O20150928000501 DC Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 2 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bethesda, MD; McLean, VA
O20150928001050 DE Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wilmington, DE
O20151015002221 NJ Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 2 practitioners
11 other NPIs on this enrollment
Practice locations: Middlesex, NJ; Moorestown, NJ; Summit, NJ
O20151028002416 GA Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 3 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alpharetta, GA; Atlanta, GA; Evans, GA; Greensboro, GA
O20151105000064 MD Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baltimore, MD; Columbia, MD; Forest Hill, MD
O20160105002652 NY Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 9 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New York, NY; Victor, NY; Rye, NY; Hewlett, NY; Great Neck, NY
O20160126001729 FL Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 6 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Port St Lucie, FL; St Petersburg, FL; Tampa, FL; The Villages, FL; Titusville, FL; Vero Beach, FL; Fort Lauderdale, FL; Weston, FL…
O20160831002303 SC Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 3 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Daniel Island, SC; Murrells Inlet, SC; Bluffton, SC
O20161103002267 WA Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 2 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Liberty Lake, WA; Newcastle, WA; Seattle, WA; Yakima, WA
O20180426002520 OR Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 2 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bend, OR; Jacksonville, OR; Portland, OR
O20180427000056 LA Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Orleans, LA
O20180521002543 KS Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Leawood, KS; Manhattan, KS; Wichita, KS
O20180619003615 NC Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greensboro, NC
O20181026000876 WI Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 2 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fox Point, WI; Kewaunee, WI
O20191001001297 ME Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kittery Point, ME
O20200428000235 MI Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 4 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ann Arbor, MI; Royal Oak, MI; Detroit, MI; Bloomfield Hills, MI
O20221130003004 OH Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 2 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Loveland, OH; Portsmouth, OH
O20230719004222 TN Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 2 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: College Grove, TN; Knoxville, TN
O20231207000799 ID Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 7 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Idaho Falls, ID; Eagle, ID; Boise, ID
O20231222001029 NV Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 1 practitioner
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Las Vegas, NV
O20240828002055 KY Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 1 practitioner
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Louisville, KY
O20241029000575 CT Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 4 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenwich, CT; Ridgefield, CT; New Britain, CT
O20241217003934 NE Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 3 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Omaha, NE; Papillion, NE
O20241218001613 IA Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 1 practitioner
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clive, IA
O20241230001689 IN Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 2 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Carmel, IN

National Provider Directory

Locations

18523 Corwin Rd
#102
Apple Valley, CA 92307
Phone (760) 242-4444

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD
    Plans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
2085R0202X Yes

Addresses

Primary practice location

17260 Bear Valley Rd
Suite 109
Victorville, CA 92395-7777

Mailing address

1510 Cotner Ave
Los Angeles, CA 90025-3303
Phone (310) 445-2851

Other names

  • Elite Advanced Imaging Doing business as

Other providers in Victorville, CA

All providers in Victorville, CA · Diagnostic Radiology Physician in California

Sources for this page

Verify at the official NPI Registry.