Active NPI
David Leroy Redding, DO
- Sports Medicine (Neuromusculoskeletal Medicine) Physician
- Pomona, CA
National Provider Identifier
1215050299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Neuromusculoskeletal Medicine) Physician
- License
- 20A6636
- Practice address
- 795 E Second Street
Suite 5
Pomona, CA 91766-2007 - Phone
- (909) 865-2565
- Fax
- (909) 865-2955
- NPI assigned
- Apr 6, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Neuromusculoskeletal Medicine) Physician | 204C00000X | 20A6636 | CA | Primary |
| Hospice and Palliative Medicine (Family Medicine) Physician | 207QH0002X | 20A6636 | CA |
Addresses
Primary practice location
795 E Second Street
Suite 5
Pomona, CA 91766-2007
Mailing address
795 E Second Street
Suite 5
Pomona, CA 91766-2007
Phone (909) 865-2565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX66360 | Medicaid | CA |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120320000098 | CA | Practitioner - Osteopathic Manipulative Medicine | 9032379672 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Osteopathic Manipulative Medicine
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
795 E 2ND St
Pomona, CA 91766-2007
Phone (909) 469-8673
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.49 of 100
- Quality
- 68.78
- Improvement activities
- 40
- Cost
- 78.85
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A6636 | CA | MD | Sports Medicine (Neuromusculoskeletal Medicine) Physician |
| 6636 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western University of Health Sciences | Current | Accepting new patients | |
| Western University of Health Sciences | Current | Accepting new patients | |
| Pomona Valley Hospital Medical Center | Past | Accepting new patients |
Locations
795 E 2nd St
Ste 5
Pomona, CA 91766
Phone (909) 706-3877
795 E 2nd St
Ste 8
Pomona, CA 91766
Phone (909) 469-8673
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.
-
- Pharmacy
- Pomona, CA
- NPI 1295051779
-
- General Acute Care Hospital
- Pomona, CA
- NPI 1518067586
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339718400000",
"number": "1215050299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "795 E SECOND STREET",
"address_2": "SUITE 5",
"city": "POMONA",
"state": "CA",
"postal_code": "917662007",
"telephone_number": "909-865-2565",
"fax_number": "909-865-2955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "795 E SECOND STREET",
"address_2": "SUITE 5",
"city": "POMONA",
"state": "CA",
"postal_code": "917662007",
"telephone_number": "909-865-2565",
"fax_number": "909-865-2955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDDING",
"first_name": "DAVID",
"middle_name": "LEROY",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-06",
"last_updated": "2012-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "204C00000X",
"taxonomy_group": "",
"desc": "Neuromusculoskeletal Medicine, Sports Medicine",
"state": "CA",
"license": "20A6636",
"primary": true
},
{
"code": "207QH0002X",
"taxonomy_group": "",
"desc": "Family Medicine, Hospice and Palliative Medicine",
"state": "CA",
"license": "20A6636",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00AX66360",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.