Individual provider Active NPI

Emmanuel P Katsaros, D.O.

  • Rheumatology Physician
  • Pomona, CA
National Provider Identifier
1144240961
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
20A6857 Issued in CA
Practice address
795 E 2ND St Ste 7
Pomona, CA 91766-2007
Phone
(909) 865-2565
Fax
(909) 865-2955
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 20A6857 CA Primary

Addresses

Primary practice location

795 E 2ND St Ste 7
Pomona, CA 91766-2007

Mailing address

795 E 2ND St
Suite 5
Pomona, CA 91766-2007
Phone (909) 865-2565

Other identifiers 1

IdentifierTypeStateIssuer
00AX86570MedicaidCA

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
I20040701000915 CA Practitioner - RheumatologyPractitioner - Internal Medicine 0749267359 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of RiversideGroup PAC ID 6507754488, 190 clinicians

Practice addresses (Care Compare)

26600 Cactus Ave
Moreno Valley, CA 92555-3901

795 E 2ND St
Pomona, CA 91766-2007
Phone (909) 469-8673

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.49 of 100Reported as group
Quality
68.78
Improvement activities
40
Cost
78.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6857CAMDMental Health Counselor
20A6857CAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside Current Accepting new patients
County of Riverside CurrentSince Aug 1, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Western University of Health Sciences CurrentSince Jan 4, 2014 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Apr 11, 2017 Accepting new patients
Western University of Health Sciences Rheumatology Current Accepting new patients
Western University of Health Sciences CurrentSince Jan 4, 2014 Accepting new patients
County of Riverside CurrentSince Aug 1, 2023 Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

11370 Anderson St
Ste 31503625
Loma Linda, CA 92354
Phone (909) 558-2191

11370 Anderson St
Ste 3300
Loma Linda, CA 92354
Phone (909) 478-6191

11370 Anderson St
#3300
Loma Linda, CA 92354
Phone (909) 558-2799

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26600 Cactus Ave
Ste 300
Moreno Valley, CA 92555
Phone (800) 720-9553

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

795 E 2nd St
Ste 8
Pomona, CA 91766
Phone (909) 469-8673

795 E 2nd St
Ste 7
Pomona, CA 91766
Phone (909) 469-8673

795 E 2nd St
Ste 5
Pomona, CA 91766
Phone (909) 706-3877

8686 Haven Ave
Ste 200
Rancho Cucamonga, CA 91730
Phone (909) 706-3950

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 12

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1144240961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 E 2ND ST",
            "address_2": "SUITE 5",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662007",
            "telephone_number": "909-865-2565",
            "fax_number": "909-865-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 E 2ND ST STE 7",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662007",
            "telephone_number": "909-865-2565",
            "fax_number": "909-865-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATSAROS",
        "first_name": "EMMANUEL",
        "middle_name": "P",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "20A6857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX86570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.