Palm Desert Radiology Medical Group, Inc

Key facts

NPI

1124079868

Entity type

Organization (NPI type 2)

Primary specialty

Diagnostic Radiology Physician 2085R0202X

Legal business name

PALM DESERT RADIOLOGY MEDICAL GROUP, INC

Practice address

39000 Bob Hope Dr
Rancho Mirage, CA 92270

Phone

(760) 837-8449

Fax

(775) 624-9774

NPI assigned

May 15, 2006

Organization subpart

No

Authorized official

Name

Dr. Mehran K. Elly, M.D. NPI 1053361790

Title

President

Phone

(760) 837-8449

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 178

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

• Mehran K. Elly, M.D., PH.D Diagnostic Radiology Physician · Rancho Mirage, CA · NPI 1053361790
  Medicare reassignment Care Compare group NPD Authorized official CA · DIAGNOSTIC RADIOLOGY
• Haroutun Abrahamian, M.D. Diagnostic Radiology Physician · Maywood, CA · NPI 1952533960
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Scott Aaron Atkins, M.D. Neuroradiology Physician · San Diego, CA · NPI 1164712576
  Medicare reassignment Care Compare group NPD CA
• Daniel Diaz, FNP Family Nurse Practitioner · Rancho Mirage, CA · NPI 1831964121
  Medicare reassignment Care Compare group NPD CA
• Azadeh Elmi, M.D. Diagnostic Radiology Physician · San Diego, CA · NPI 1699114397
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Bayani V. Evangelista, M.D. Diagnostic Radiology Physician · Rancho Mirage, CA · NPI 1083664262
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Adele Alexandra Fields, MD Diagnostic Radiology Physician · Rancho Mirage, CA · NPI 1003071051
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Kristopher L Foreman, MD Diagnostic Radiology Physician · Rancho Mirage, CA · NPI 1346494044
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Fregenet Zekiewos Gichamo, MD Diagnostic Radiology Physician · San Diego, CA · NPI 1265013072
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Khushboo Gupta, MD Nuclear Medicine Physician · Rancho Mirage, CA · NPI 1114420304
  Medicare reassignment Care Compare group NPD CA
• Barbara Nickel Hamilton, M.D. Diagnostic Radiology Physician · Palm Springs, CA · NPI 1396982336
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Sidharth Handa, M.D. Diagnostic Radiology Physician · Beverly Hills, CA · NPI 1538514831
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Farhad Houriani, M.D. Diagnostic Radiology Physician · North Hollywood, CA · NPI 1376590471
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Brian Hurt, M.D. Diagnostic Radiology Physician · San Diego, CA · NPI 1306370465
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Hessam Mahdavi, MD Internal Medicine Physician · Rancho Mirage, CA · NPI 1851393300
  Medicare reassignment Care Compare group NPD CA
• Arian Edwin Mashhood, M.D. Neuroradiology Physician · Palo Alto, CA · NPI 1629411061
  Medicare reassignment Care Compare group NPD CA
• Ahmed A Mohammed, M.D. Diagnostic Radiology Physician · Rancho Mirage, CA · NPI 1063752210
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Luis Enrique Monterroso, MD Diagnostic Radiology Physician · San Diego, CA · NPI 1487282703
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Josephine Nguyen, MD Diagnostic Radiology Physician · Rancho Mirage, CA · NPI 1184781114
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Stephen A Saponaro, MD Diagnostic Radiology Physician · Rancho Mirage, CA · NPI 1417912684
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Dmitriy Shnayderman, M.D. Vascular & Interventional Radiology Physician · Manteca, CA · NPI 1346687670
  Medicare reassignment Care Compare group NPD CA
• Gbenga Adeyemi Shogbesan, MD Diagnostic Radiology Physician · San Diego, CA · NPI 1588169171
  Medicare reassignment Care Compare group NPD DIAGNOSTIC RADIOLOGY · NC
• Glenn R Slocum, M.D. Diagnostic Radiology Physician · Irvine, CA · NPI 1588614564
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Mark Q. Smith, MD Diagnostic Radiology Physician · Rancho Mirage, CA · NPI 1831374289
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY
• Steven M Sorenson, M.D. Diagnostic Radiology Physician · Redlands, CA · NPI 1275585507
  Medicare reassignment Care Compare group NPD CA · DIAGNOSTIC RADIOLOGY

View all 178

Medicare participation

Medicare fee-for-service enrollment

Enrolled (35 enrollments) in CA, MI, NY, TX, VA, OR, FL, IL, WA, NV, ID, CO, CT, MA, TN, PA, DC, NJ, NC, OH, MO, GA, ME, MD, HI, OK, SC, AZ, NM, KY, NH, IA, WI, MN, IN

Medicare enrollment records

National Provider Directory

Locations

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

Addresses

Other identifiers

Other names

• Eisenhower Radiology Medical Group, Inc Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 5, 2024.

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1124079868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1629",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477060030",
            "telephone_number": "760-837-8449",
            "fax_number": "760-773-1848"
        },
        {
            "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": "92270",
            "telephone_number": "760-837-8449",
            "fax_number": "775-624-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM DESERT RADIOLOGY MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "ELLY",
        "authorized_official_first_name": "MEHRAN",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-837-8449",
        "authorized_official_name_prefix": "Dr.",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124079868",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC9030",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0012730",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ40340Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eisenhower Radiology Medical Group, Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eisenhower Radiology Medical Group, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lester D Padilla, M.D.
• William R Page, MD
• Paige Dubin MD PC
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• Heather L Palmer, P.A.
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All providers in Rancho Mirage, CA · Diagnostic Radiology Physician in California