Individual provider Active NPI

Bradley Arin Restivo, M.D.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Upland, CA
National Provider Identifier
1245789916
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
A188083 Issued in CA
Practice address
1100 San Bernardino Rd Ste 1100
Upland, CA 91786-4952
Phone
(909) 949-2242
Fax
(909) 981-5783
NPI assigned
Sep 22, 2016
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X A188083 CA Primary

Addresses

Primary practice location

1100 San Bernardino Rd Ste 1100
Upland, CA 91786-4952

Mailing address

PO Box 512185
Los Angeles, CA 90051-0185

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@cityofhope.direct-ci.com CITY OF HOPE MEDICAL FOUNDATION

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
I20230810002648 CA Practitioner - Hospice/Palliative Care 7517245475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Southern Illinois University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
City of Hope Medical FoundationGroup PAC ID 3779751656, 964 clinicians

Practice addresses (Care Compare)

1100 San Bernardino Rd
Suite 1100
Upland, CA 91786-4923
Phone (909) 949-2242

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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
A188083CAMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Foundation CurrentSince Jul 25, 2023 Accepting new patients
City of Hope Medical Foundation PastSince Jun 27, 2021 Accepting new patients

Locations

1500 Duarte Rd
Duarte, CA 91010
Phone (626) 359-8111

1601 Avocado Ave
Newport Beach, CA 92660
Phone (949) 763-2204

6939 Palm Ct
Riverside, CA 92506
Phone (760) 416-4832

209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111

1100 San Bernardino Rd
Ste 1100
Upland, CA 91786
Phone (909) 949-2242

Interoperability endpoints

  • Direct secure messaging: brestivo161188@cityofhope.direct-ci.com
  • Direct secure messaging: direct@cityofhope.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1245789916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512185",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SAN BERNARDINO RD STE 1100",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864952",
            "telephone_number": "909-949-2242",
            "fax_number": "909-981-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESTIVO",
        "first_name": "BRADLEY",
        "middle_name": "ARIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-22",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "A188083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
            "address_1": "1500 Duarte Rd",
            "city": "Duarte",
            "state": "CA",
            "country_code": "US",
            "postal_code": "910103012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.