Individual provider Active NPI

John Joseph McGovern, M.D.

  • Diagnostic Radiology Physician
  • Santa Rosa, CA
National Provider Identifier
1174613871
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G57627 Issued in CA
Practice address
121 Sotoyome St
Santa Rosa, CA 95405-4823
Phone
(707) 546-4062
Fax
(707) 525-4095
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X G57627 CA
Nuclear Radiology Physician 2085N0904X G57627 CA
Diagnostic Radiology Physician 2085R0202X G57627 CA Primary
Diagnostic Ultrasound Physician 2085U0001X G57627 CA

Addresses

Primary practice location

121 Sotoyome St
Santa Rosa, CA 95405-4823

Mailing address

PO Box 5651
Orange, CA 92863-5651
Phone (714) 571-5000

Other identifiers 1

IdentifierTypeStateIssuer
00G576270MedicaidCA

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
I20060221000594 CA Practitioner - Diagnostic Radiology 8022024538 Reassigns benefits to 13 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, San Francisco School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norcal ImagingGroup PAC ID 7911099346, 79 clinicians
Modesto Advanced Diagnostic Imaging Medical CenterGroup PAC ID 1850336736, 62 clinicians
Stockton Diagnostic ImagingGroup PAC ID 0749386894, 59 clinicians
Radnet Medical Imaging-San FranciscoGroup PAC ID 9830283761, 35 clinicians
Santa Rosa Imaging Medical CenterGroup PAC ID 2567408859, 20 clinicians
Diagnostic Radiological ImagingGroup PAC ID 4981680220, 52 clinicians

Practice addresses (Care Compare)

114 La Casa Via
Suite 100
Walnut Creek, CA 94598-3044
Phone (925) 937-6100

157 E Coolidge Ave
Modesto, CA 95350-4504
Phone (209) 524-6800

1801 E March LN
Suite A130
Stockton, CA 95210-6650
Phone 2094759871209474

3440 California St
San Francisco, CA 94118-1837
Phone (415) 922-6767

3536 Mendocino Ave
Suite 280
Santa Rosa, CA 95403-3634
Phone (707) 579-8226

79 Scripps Dr
Suite 100
Sacramento, CA 95825-6208
Phone (916) 921-1300

Merit-based Incentive Payment System (MIPS)

Final score
84.83 of 100Reported as group
Quality
63.33
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.83 of 100Reported as group
Quality
63.33
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.83 of 100Reported as group
Quality
63.33
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.25 of 100Reported as group
Quality
75
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.83 of 100Reported as group
Quality
63.33
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G57627CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Aug 9, 2021 Accepting new patients
San Fernando Valley Interventional Radiology and Imaging Center CurrentSince Aug 9, 2021 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology Current Accepting new patients
Modesto Advanced Diagnostic Imaging Medical Center Diagnostic Radiology CurrentSince Aug 9, 2021 Accepting new patients
Desert Advanced Imaging Medical Center Diagnostic Radiology CurrentSince Aug 9, 2021 Accepting new patients
Norcal Imaging Diagnostic Radiology CurrentSince Aug 1, 2021 Accepting new patients
Pronet Imaging Medical Group, Inc. Diagnostic Radiology CurrentSince Aug 9, 2021 Accepting new patients
Fresno Imaging Center Diagnostic Radiology CurrentSince Aug 9, 2021 Accepting new patients
Diagnostic Radiological Imaging Diagnostic Radiology CurrentSince Aug 9, 2021 Accepting new patients
Norcal Imaging Diagnostic Radiology CurrentSince Aug 1, 2021 Accepting new patients
Santa Rosa Imaging Medical Center Diagnostic Radiology CurrentSince Aug 9, 2021 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Aug 9, 2021 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Aug 9, 2021 Accepting new patients
Stockton Diagnostic Imaging Diagnostic Radiology CurrentSince Aug 9, 2021 Accepting new patients
Redwood Regional Medical Group, Inc. Past Accepting new patients
Redwood Regional Medical Group Inc Diagnostic Radiology Past Accepting new patients

Locations (25 of 29)

18523 Corwin Rd
Ste J
Apple Valley, CA 92307
Phone (760) 242-4444

8750 Wilshire Blvd
Ste 100
Beverly Hills, CA 90211
Phone (310) 689-3100

2601 W Alameda Ave
Ste 101
Burbank, CA 91505
Phone (818) 843-7462

801 S Main St
Ste 101
Corona, CA 92882
Phone (951) 682-1099

801 S Main St
Ste 205
Corona, CA 92882
Phone (951) 351-1025

16311 Ventura Blvd
Ste 120
Encino, CA 91436
Phone (818) 817-7707

16130 Ventura Blvd
Ste 100
Encino, CA 91436
Phone (818) 933-2020

2201 Walnut Ave
Ste 150
Fremont, CA 94538
Phone (510) 713-1234

6191 N Thesta St
Fresno, CA 93710
Phone (559) 435-7200

6107 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-4433

9191 Westminster Ave
Ste 105
Garden Grove, CA 92844
Phone (714) 583-6314

2679 Zoe Ave
Huntington Park, CA 90255
Phone (323) 584-3333

11360 Mountain View Ave
Ste C
Loma Linda, CA 92354
Phone (909) 478-3300

3715 E South St
Long Beach, CA 90805
Phone (562) 602-0700

3320 N Los Coyotes Diagonal
Ste 120
Long Beach, CA 90808
Phone (562) 627-0903

1516 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2843

27168 Newport Rd
Ste B
Menifee, CA 92584
Phone (951) 566-5725

157 E Coolidge Ave
Modesto, CA 95350
Phone (209) 524-6800

25395 Hancock Ave
Ste 110
Murrieta, CA 92562
Phone (951) 696-4230

25395 Hancock Ave
#1101112
Murrieta, CA 92562
Phone (951) 696-4230

72855 Fred Waring Dr
Palm Desert, CA 92260
Phone (760) 837-1420

2601 E Tahquitz Canyon Way
Palm Springs, CA 92262
Phone (760) 318-2980

79 Scripps Dr
Ste 100
Sacramento, CA 95825
Phone (916) 921-1200

3536 Mendocino Ave
Ste 280
Santa Rosa, CA 95403
Phone (707) 579-8226

1801 E March Ln
Ste A130
Stockton, CA 95210
Phone (209) 475-9871

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1174613871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5651",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928635651",
            "telephone_number": "714-571-5000",
            "fax_number": "714-571-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 SOTOYOME ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054823",
            "telephone_number": "707-546-4062",
            "fax_number": "707-525-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "CA",
            "license": "G57627",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "CA",
            "license": "G57627",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G57627",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "CA",
            "license": "G57627",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G576270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.