Individual provider Active NPI

Richard J Conner, MD

  • Urology Physician
  • Murrieta, CA
National Provider Identifier
1275633364
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
G67933 Issued in CA
Practice address
25495 Medical Center Dr
Ste 204
Murrieta, CA 92562-4902
Phone
(951) 698-1901
Fax
(951) 698-1074
NPI assigned
Sep 25, 2006
Last updated
Sep 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X G67933 CA Primary

Addresses

Primary practice location

25495 Medical Center Dr
Ste 204
Murrieta, CA 92562-4902

Mailing address

31547 Enfield Lane
Temecula, CA 92591

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
I20081006000061 CA Practitioner - Urology 2062580947 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G67933CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri Valley Urology PastSince Jun 1, 2000 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rconner181879@direct.llu.edu
  • Direct secure messaging: rjc103pcs1390@primeclinicalsystems.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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1275633364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31547 ENFIELD LANE",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "92591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25495 MEDICAL CENTER DR",
            "address_2": "STE 204",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925624902",
            "telephone_number": "951-698-1901",
            "fax_number": "951-698-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "RICHARD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "G67933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.