Individual provider Active NPI

Vicky Ninh Mai, D.O

  • Family Medicine Physician
  • Riverside, CA
National Provider Identifier
1346300191
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A7549 Issued in CA
Practice address
4244 Riverwalk Pkwy Ste 150
Riverside, CA 92505-3373
Phone
(951) 781-6335
Fax
(951) 781-6365
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A7549 CA Primary
General Practice Physician 208D00000X 20A7549 CA

Addresses

Primary practice location

4244 Riverwalk Pkwy Ste 150
Riverside, CA 92505-3373

Mailing address

4310 Orange St
Riverside, CA 92501-3829
Phone (951) 781-6335

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
I20040409000662 CA Practitioner - Family PracticePractitioner - General Practice 0345234639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4310 Orange St
Riverside, CA 92501-3829
Phone (951) 781-6335

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Family Physicians, a Professional Medical Corporation Family Medicine CurrentSince Sep 24, 2010 Accepting new patients
Uhs Corona Inc Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Doctors Hospital of Riverside LLC Past Accepting new patients

Locations

161 N McKinley St
Corona, CA 92879
Phone (909) 272-4812

4244 Riverwalk Pkwy
Ste 150
Riverside, CA 92505
Phone (951) 335-4660

4310 Orange St
Riverside, CA 92501
Phone (951) 781-6335

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: vicky.mai.p1@direct.famdoc.nextgenshare.com
  • Direct secure messaging: vicky.mai.p2@direct.famdoc.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1346300191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 ORANGE ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013829",
            "telephone_number": "951-781-6335",
            "fax_number": "951-208-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4244 RIVERWALK PKWY STE 150",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053373",
            "telephone_number": "951-781-6335",
            "fax_number": "951-781-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAI",
        "first_name": "VICKY",
        "middle_name": "NINH",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7549",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A7549",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.