NPIMap

Organization Active NPI

Neighborhood Medical Clinic of Riverside Inc

Doing business as Dogon Behavioral Medical Group and Dogon Psychiatric Services

  • Psychiatry Physician
  • Riverside, CA
National Provider Identifier
1184782583
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G549970 Issued in CA
Legal business name
NEIGHBORHOOD MEDICAL CLINIC OF RIVERSIDE INC
Doing business as
Dogon Behavioral Medical Group and Dogon Psychiatric Services
Practice address
4960 Arlington Ave
Suite B
Riverside, CA 92504-2738
Phone
(951) 341-8930
Fax
(951) 341-8932
NPI assigned
Dec 5, 2006
Last updated
Feb 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Authorized official

Name
Dr. Samuel Dey, M.D.NPI 1447271242
Title
Administrator
Phone
(951) 341-8935

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G549970 CA Primary

Addresses

Primary practice location

4960 Arlington Ave
Suite B
Riverside, CA 92504-2738

Mailing address

PO Box 5109
Riverside, CA 92517-5109
Phone (951) 341-8935

Other identifiers 6

IdentifierTypeStateIssuer
ZZZ65471ZOtherCABLUE SHIELD
33GHAIOtherCACOUNTY SPECIALIST ID
7078316OtherCAAETNA
ZZZ16441OtherCATRIWEST
DE8880OtherCAPALMETTO GBA
33GH00OtherCACOUNTY SPECIALIST ID

Other names 1

  • Dogon Behavioral Medical Group and Dogon Psychiatric Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050721000209 CA Part B Supplier - Clinic/Group Practice 8325075310 Receives reassigned benefits from 2 practitioners
Practice locations: Riverside, CA

National Provider Directory

National Provider Directory
Tax ID family
Dogon Behavioral Medical Group and Dogon Psychiatric Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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 & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1184782583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5109",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925175109",
            "telephone_number": "951-341-8935",
            "fax_number": "951-341-8932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 ARLINGTON AVE",
            "address_2": "SUITE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925042738",
            "telephone_number": "951-341-8930",
            "fax_number": "951-341-8932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORHOOD MEDICAL CLINIC OF RIVERSIDE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "DEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "951-341-8935",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G549970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ65471Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNTY SPECIALIST ID",
            "identifier": "33GHAI",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7078316",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "ZZZ16441",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "DE8880",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNTY SPECIALIST ID",
            "identifier": "33GH00",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dogon Behavioral Medical Group and Dogon Psychiatric Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dogon Behavioral Medical Group and Dogon Psychiatric Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.