Pediatric Cardiology Specialists Medical Group Inc

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

00A425260 Issued in CA

Legal business name

PEDIATRIC CARDIOLOGY SPECIALISTS MEDICAL GROUP INC

Practice address

350 E Vanderbilt Way Ste a
San Bernardino, CA 92408-3593

Phone

(909) 886-5200

Fax

(949) 336-3827

NPI assigned

Jul 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mohammad Kanakriyeh, MDNPI 1164512281

Title

President

Phone

(909) 886-5200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mohammad Kanakriyeh, MD Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohammad S Kanakriyeh, MD

  • Pediatric Cardiology Physician
  • San Bernardino, CA
  • NPI 1164512281
  Medicare reassignment Authorized official
• Gail Marks, MD

  • Pediatrics Physician
  • San Bernardino, CA
  • NPI 1700813698
  NPD (past)
• Heather Vickers

  • Pediatrics Physician
  • Loma Linda, CA
  • NPI 1134412547
  NPD (past)

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1356541429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 E VANDERBILT WAY STE A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083593",
            "telephone_number": "909-886-5200",
            "fax_number": "949-336-3827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E VANDERBILT WAY STE A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083593",
            "telephone_number": "909-886-5200",
            "fax_number": "949-336-3827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARDIOLOGY SPECIALISTS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "KANAKRIYEH",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-886-5200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "00A425260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356541429",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mohammad Kanakriyeh, MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elsa Olivia Pearce
• Charles Pearson, MFTI
• Pearsons Medical Group Pharmacy (Pearsons Medical Group Pharmacy - Long Term Care)
• Pearsons Medical Group Pharmacy
• Lisa Pederson, SLPA
• Keanna M Pedroza
• Sandra Peeke, FNP
• Geovanny Pelayo
• Erika Pena
• Rebecca Pena

• Pediatric Cardiology Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Pediatric Cardiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.