Active NPI
Phill Victor Halamandaris, M.D.
- Psychiatry Physician
- Indio, CA
National Provider Identifier
1194944736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G66098
- Practice address
- 47825 Oasis St
Indio Mental Health Clinic
Indio, CA 92201-6950 - Phone
- (760) 863-8455
- Fax
- (760) 863-8587
- NPI assigned
- Apr 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G66098 | CA | Primary |
Addresses
Primary practice location
47825 Oasis St
Indio Mental Health Clinic
Indio, CA 92201-6950
Mailing address
47825 Oasis St
Indio Mental Health Clinic
Indio, CA 92201-6950
Phone (760) 863-8455
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- University of Southern California Keck School of Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
47825 Oasis St
Indio, CA 92201-6950
Phone (760) 863-8517
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66098 | CA | MD | Clinical Social Worker |
| G66098 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Riverside | Current | Accepting new patients | |
| County of Riverside | Current | Accepting new patients | |
| County of Riverside | Current | Accepting new patients |
Locations
1330 W Ramsey St
Ste 100
Banning, CA 92220
Phone (951) 849-7142
47825 Oasis St
Indio, CA 92201
Phone (760) 863-8455
Organizations & group practices 3
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.
-
- Federally Qualified Health Center (FQHC)
- Indio, CA
- NPI 1023122967
-
- Community/Behavioral Health Agency
- Riverside, CA
- NPI 1487096020
-
- Clinical Medical Laboratory
- Riverside, CA
- NPI 1952496010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377561600000",
"number": "1194944736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47825 OASIS ST",
"address_2": "INDIO MENTAL HEALTH CLINIC",
"city": "INDIO",
"state": "CA",
"postal_code": "922016950",
"telephone_number": "760-863-8455",
"fax_number": "760-863-8587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47825 OASIS ST",
"address_2": "INDIO MENTAL HEALTH CLINIC",
"city": "INDIO",
"state": "CA",
"postal_code": "922016950",
"telephone_number": "760-863-8455",
"fax_number": "760-863-8587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALAMANDARIS",
"first_name": "PHILL",
"middle_name": "VICTOR",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-24",
"last_updated": "2013-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G66098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.