Individual provider Active NPI

Matei Popa-Radu, D.O.

  • Cardiovascular Disease Physician
  • Riverside, CA
National Provider Identifier
1255561726
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
20A16191 Issued in CA
Practice address
4646 Brockton Ave Ste 301
Riverside, CA 92506-0103
Phone
(951) 682-6900
Fax
(951) 682-6905
NPI assigned
Jul 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 20A16191 CA Primary

Addresses

Primary practice location

4646 Brockton Ave Ste 301
Riverside, CA 92506-0103

Mailing address

4646 Brockton Ave Ste 301
Riverside, CA 92506-0103
Phone (951) 682-6900

Other identifiers 1

IdentifierTypeStateIssuer
20A16191OtherCAOSTEOPATHIC MEDICAL BOARD OF CALIFORNIA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20180503001235 CA Practitioner - Cardiovascular Disease (Cardiology) 8820399751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Nova Southeastern College of Osteo Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-2000

27300 Iris Ave
Moreno Valley, CA 92555-4802
Phone (951) 243-0811

27350 Iris Ave
Moreno Valley, CA 92555-4802
Phone (866) 984-7483

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16191CAMDChiropractor
20A16191CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jul 1, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 1, 2024 Accepting new patients
Advanced Heart & Vascular Physicians Inc CurrentSince Mar 24, 2018 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Palmetto Ekg & Echo Readers, PA Cardiovascular Disease Past Accepting new patients

Locations

16003 Tuscola Rd
Ste F
Apple Valley, CA 92307
Phone (760) 242-8221

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

4646 Brockton Ave
Ste 301
Riverside, CA 92506
Phone (951) 682-6900

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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 2

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": "1247961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1255561726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 BROCKTON AVE STE 301",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925060103",
            "telephone_number": "951-682-6900",
            "fax_number": "951-682-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 BROCKTON AVE STE 301",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925060103",
            "telephone_number": "951-682-6900",
            "fax_number": "951-682-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPA-RADU",
        "first_name": "MATEI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-19",
        "last_updated": "2024-10-25",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "20A16191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSTEOPATHIC MEDICAL BOARD OF CALIFORNIA",
            "identifier": "20A16191",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.