Volta Medical Group

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

VOLTA MEDICAL GROUP

Practice address

9415 Mission Blvd Ste P
Jurupa Valley, CA 92509-2600

Phone

(833) 865-8263

NPI assigned

Apr 10, 2022

Organization subpart

No

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

Authorized official

Name

Maxwell Setsoafia

Title

Ceo

Phone

(310) 308-4550

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Volta Medical Group2 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.

• Volta Medical Group

  • Primary Care Clinic/Center
  • Moreno Valley, CA
  • NPI 1174214225
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Volta Medical Group

  • Primary Care Clinic/Center
  • Moreno Valley, CA
  • NPI 1174214225
  NPPES parent name

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michele T Vargas, DO

  • Emergency Medicine Physician
  • Glendora, CA
  • NPI 1306873583
  Medicare reassignment NPD
• Catherine Fung-Bagamasbad, FNP

  • Family Nurse Practitioner
  • Jurupa Valley, CA
  • NPI 1437979697
  NPD
• Prince Ocansey, FNP

  • Family Nurse Practitioner
  • San Bernardino, CA
  • NPI 1164708640
  NPD
• Silas Gyimah, M.D

  • Family Medicine Physician
  • Desert Hot Springs, CA
  • NPI 1639522006
  NPD (past)
• Samuel Penney Smith, M.D.

  • Psychiatry Physician
  • Los Angeles, CA
  • NPI 1295802700
  NPD (past)

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

{
    "created_epoch": "1649548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683936000000",
    "number": "1245972306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9415 MISSION BLVD STE P",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "925092600",
            "telephone_number": "833-865-8263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 MISSION BLVD STE P",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "925092600",
            "telephone_number": "833-865-8263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24318 Hemlock Ave Ste E1",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925577225",
            "country_code": "US",
            "telephone_number": "951-243-5050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VOLTA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-10",
        "last_updated": "2023-05-13",
        "certification_date": "2023-05-13",
        "status": "A",
        "authorized_official_last_name": "SETSOAFIA",
        "authorized_official_first_name": "MAXWELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-308-4550"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa Maria Vielmas
• Jacqueline Villalta
• Janely Villanueva
• Vivian Villasenor, DMD
• Esmeralda Villegas
• Katherine Wallen, OTR/L
• James Bernard Wandrie
• We Connect Transport LLC
• Jenna West
• Western Dental Services, Inc.

• Primary Care Clinic/Center in Jurupa Valley, CA
• Providers in Jurupa Valley, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.