Individual provider Active NPI

Margery Ulema Chirwa, M.D.

  • Family Medicine Physician
  • Moreno Valley, CA
National Provider Identifier
1205952959
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G64481 Issued in CA
Practice address
12980 Frederick St
Suite C
Moreno Valley, CA 92553-5263
Phone
(951) 242-5760
Fax
(951) 242-5830
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G64481 CA Primary

Addresses

Primary practice location

12980 Frederick St
Suite C
Moreno Valley, CA 92553-5263

Mailing address

264 N Highland Springs Ave
Suite 2a
Banning, CA 92220-3082
Phone (951) 845-8856

Other identifiers 2

IdentifierTypeStateIssuer
G64481OtherCATRICARE
00G644810MedicaidCA

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
I20101116000727 CA Practitioner - Family Practice 6002001062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Qazi Medical Group, Inc.Group PAC ID 6608823729, 3 clinicians

Practice addresses (Care Compare)

12980 Frederick St
Suite C
Moreno Valley, CA 92553-5263
Phone (951) 242-5760

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G64481CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Qazi Medical Group, Inc. Family Medicine CurrentSince Aug 1, 2010 Accepting new patients
San Gorgonio Memorial Hospital Past Accepting new patients

Locations

264 N Highland Springs Ave
Ste 2A
Banning, CA 92220
Phone (951) 845-8589

12980 Frederick St
Ste C
Moreno Valley, CA 92553
Phone (951) 242-5760

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205952959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 N HIGHLAND SPRINGS AVE",
            "address_2": "SUITE 2A",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203082",
            "telephone_number": "951-845-8856",
            "fax_number": "951-845-7256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12980 FREDERICK ST",
            "address_2": "SUITE C",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925535263",
            "telephone_number": "951-242-5760",
            "fax_number": "951-242-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIRWA",
        "first_name": "MARGERY",
        "middle_name": "ULEMA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G64481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "G64481",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G644810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.