Mirage Medical Group

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

MIRAGE MEDICAL GROUP

Practice address

44650 Village CT Ste 100
Palm Desert, CA 92260-3812

Phone

(760) 346-4003

NPI assigned

Feb 22, 2024

Organization subpart

No

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

Authorized official

Name

Zoran Rubakovich

Title

Executive Director

Phone

(760) 346-4003

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

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

• Maryam Bahreini, M.D

  • Obstetrics & Gynecology Physician
  • Palm Desert, CA
  • NPI 1164612099
  Medicare reassignment NPD
• Carol Yagher, PAC

  • Medical Physician Assistant
  • Indio, CA
  • NPI 1417086562
  Medicare reassignment

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1265298756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44650 VILLAGE CT STE 100",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603812",
            "telephone_number": "760-346-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44650 VILLAGE CT STE 100",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603812",
            "telephone_number": "760-346-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRAGE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-22",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "RUBAKOVICH",
        "authorized_official_first_name": "ZORAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "760-346-4003"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Santo Svetislav Milosevich, PHARMD
• Mind by Design Wellness Center, Inc
• Mark Morton Minot, MD, PH.D, MBA, MSEE
• Heather H Minshall, LMFT 51143
• Miracle Ranch
• Mirage Medical Group Center
• Ivana Miranda
• Matthew Donald Misuraca, MA, LMFT
• Cindy Miyamoto, MS., LMFT
• Keeley Ruth Mizell

• Obstetrics & Gynecology Physician in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.