Individual provider Active NPI

Scott Andrew Allen, M.D.

  • Internal Medicine Physician
  • Moreno Valley, CA
National Provider Identifier
1184681710
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD09243 Issued in RI
Practice address
26520 Cactus Ave
First Floor: Access Clinic
Moreno Valley, CA 92555
Phone
(951) 486-5573
Fax
(951) 486-5482
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD09243 RI Primary

Addresses

Primary practice location

26520 Cactus Ave
First Floor: Access Clinic
Moreno Valley, CA 92555

Mailing address

26520 Cactus Ave
First Floor: Access Clinic
Moreno Valley, CA 92555
Phone (951) 988-9929

Other identifiers 1

IdentifierTypeStateIssuer
9020093MedicaidRI

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
I20120821000121 CA Practitioner - Internal MedicinePractitioner - Family Practice 6103912969 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD09243RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside Current Accepting new patients
County of Riverside CurrentSince Jul 1, 2022 Accepting new patients
County of Riverside CurrentSince Jul 1, 2022 Accepting new patients
Blackstone Valley Center for Internal Medicine,Inc. PastSince Jan 1, 1990 Accepting new patients
Blackstone Valley Center for Internal Medicine, Inc PastSince Jan 1, 1990 Accepting new patients

Locations

26520 Cactus Ave
Fl First
Moreno Valley, CA 92555
Phone (951) 486-5573

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

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

Interoperability endpoints

  • Direct secure messaging: sallen96853@direct.llu.edu

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1184681710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "address_2": "FIRST FLOOR: ACCESS CLINIC",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "92555",
            "telephone_number": "951-988-9929",
            "fax_number": "951-486-5482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "address_2": "FIRST FLOOR: ACCESS CLINIC",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "92555",
            "telephone_number": "951-486-5573",
            "fax_number": "951-486-5482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "SCOTT",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2024-04-26",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD09243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9020093",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.