Palm Desert Radiology Medical Group, Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

PALM DESERT RADIOLOGY MEDICAL GROUP, INC

Doing business as

Eisenhower 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

Last updated

Feb 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

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

Title

President

Phone

(760) 837-8449

Specialties & licenses 1

Addresses

Other names 1

• Eisenhower Radiology Medical Group, Inc Doing business as

Medicare fee-for-service enrollment

Enrolled 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, IN35 enrollments

Enrollment records 35

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: 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)…

Practitioners 178

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.

• Mehran K. Elly, M.D., PH.D

  • Diagnostic Radiology Physician
  • Rancho Mirage, CA
  • NPI 1053361790
  Medicare reassignment Care Compare group NPD Authorized official
• Haroutun Abrahamian, M.D.

  • Diagnostic Radiology Physician
  • Maywood, CA
  • NPI 1952533960
  Medicare reassignment Care Compare group NPD
• Scott Aaron Atkins, M.D.

  • Neuroradiology Physician
  • San Diego, CA
  • NPI 1164712576
  Medicare reassignment Care Compare group NPD
• Daniel Diaz, FNP

  • Family Nurse Practitioner
  • Rancho Mirage, CA
  • NPI 1831964121
  Medicare reassignment Care Compare group NPD
• Azadeh Elmi, M.D.

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1699114397
  Medicare reassignment Care Compare group NPD
• Bayani V. Evangelista, M.D.

  • Diagnostic Radiology Physician
  • Rancho Mirage, CA
  • NPI 1083664262
  Medicare reassignment Care Compare group NPD
• Adele Alexandra Fields, MD

  • Diagnostic Radiology Physician
  • Rancho Mirage, CA
  • NPI 1003071051
  Medicare reassignment Care Compare group NPD
• Kristopher L Foreman, MD

  • Diagnostic Radiology Physician
  • Rancho Mirage, CA
  • NPI 1346494044
  Medicare reassignment Care Compare group NPD
• Fregenet Zekiewos Gichamo, MD

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1265013072
  Medicare reassignment Care Compare group NPD
• Khushboo Gupta, MD

  • Nuclear Medicine Physician
  • Rancho Mirage, CA
  • NPI 1114420304
  Medicare reassignment Care Compare group NPD
• Barbara Nickel Hamilton, M.D.

  • Diagnostic Radiology Physician
  • Palm Springs, CA
  • NPI 1396982336
  Medicare reassignment Care Compare group NPD
• Sidharth Handa, M.D.

  • Diagnostic Radiology Physician
  • Beverly Hills, CA
  • NPI 1538514831
  Medicare reassignment Care Compare group NPD

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

{
    "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": [],
    "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"
        }
    ]
}

• Cassie Padilla, LVN
• Lester D Padilla, M.D.
• William R Page, MD
• Paige Dubin MD PC
• Juana I Pallares-Hernandez
• Palm Springs Home Health Nurses Inc
• Palm Springs Hospice and Palliative Care Inc
• Heather L Palmer, P.A.
• Praveen Panguluri, M.D.
• Daniel Jacob Panhassi, MD

• Diagnostic Radiology Physician in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.