Individual provider Active NPI

Tri Thanh Luu, M.D

  • Internal Medicine Physician
  • Loma Linda, CA
National Provider Identifier
1396056610
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A126568 Issued in CA
Practice address
11234 Anderson St Ste C
Loma Linda, CA 92354-2804
Phone
(909) 558-8131
NPI assigned
Jul 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 052111 NY
Internal Medicine Physician 207R00000X A126568 CA Primary
General Practice Physician 208D00000X A126568 CA

Addresses

Primary practice location

11234 Anderson St Ste C
Loma Linda, CA 92354-2804

Mailing address

5278 Kesling St
San Diego, CA 92117-3216
Phone (619) 865-6437

Other identifiers 1

IdentifierTypeStateIssuer
A126568MedicaidCA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150915002693 CA Practitioner - HospitalistPractitioner - Internal Medicine 2961619135 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of Vermont College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Faculty Medical Group IncGroup PAC ID 9436253515, 76 clinicians

Practice addresses (Care Compare)

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 656-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.34 of 100Reported as group
Quality
84.11
Promoting interoperability
96
Improvement activities
40
Cost
77.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
052111NYMDPharmacist
A126568CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Faculty Medical Group Inc Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
24 On Physicians of California, PC CurrentSince Sep 1, 2017 Accepting new patients

Locations

1415 Ross Ave
El Centro, CA 92243
Phone (760) 339-4045

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

Interoperability endpoints

  • Direct secure messaging: tluu24171@direct.llu.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1396056610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5278 KESLING ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921173216",
            "telephone_number": "619-865-6437",
            "fax_number": "844-578-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST STE C",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUU",
        "first_name": "TRI",
        "middle_name": "THANH",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-01",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "052111",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A126568",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A126568",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A126568",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.