Halo Medical Group

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

FNP25453 Issued in CA

Legal business name

HALO MEDICAL GROUP

Doing business as

Desert Medical Imaging

Practice address

74785 US Highway 111
Suite 101
Indian Wells, CA 92210-7128

Phone

(760) 776-8989

Fax

(760) 501-0311

NPI assigned

Jan 23, 2007

Last updated

Apr 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cory Hammond

Title

Cfo

Phone

(760) 776-8989

Specialties & licenses 8

Addresses

Other identifiers 13

Other names 1

• DESERT MEDICAL IMAGING Doing business as

Medicare fee-for-service enrollment

Enrolled in CA, GA, SC, AZ, FL, NY, NV, NJ, TX, OH, NM, NC, IL, WA, TN, MA, PR17 enrollments

Enrollment records 17

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Halo Medical Group

  dba Chico Breast Care Center II, INC.

  • Diagnostic Radiology Physician
  • Chico, CA
  • NPI 1154950236

  O20040315001110

  Same enrollment

Tax ID family

Desert Medical Imaging5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Desert Medical Imaging, a Medical Corporation

  dba Desert Medical Imaging

  • Diagnostic Radiology Physician
  • Palm Springs, CA
  • NPI 1083614929
  NPD tax ID
• Desert Medical Imaging, a Medical Corporation

  dba Desert Medical Imaging

  • Diagnostic Radiology Physician
  • Indio, CA
  • NPI 1609876549
  NPD tax ID
• Desert Medical Imaging, a Medical Corporation

  dba Desert Medical Imaging

  • Specialist
  • Indian Wells, CA
  • NPI 1811996747
  NPD tax ID
• Halo Medical Group

  dba Chico Breast Care Center II, INC.

  • Diagnostic Radiology Physician
  • Chico, CA
  • NPI 1154950236
  NPD tax ID

Locations

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 92

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.

• Jonathan William Blevins, M.D.

  • Diagnostic Radiology Physician
  • Rancho Mirage, CA
  • NPI 1477710127
  Medicare reassignment Care Compare group NPD
• Aimee P Carswell, MD

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1619156635

  TX

  Medicare reassignment Care Compare group NPD
• Alina Kravtsova Feldman, M.D.

  • Diagnostic Radiology Physician
  • Burbank, CA
  • NPI 1902225089
  Medicare reassignment Care Compare group NPD
• John Francis Feller, MD

  • Diagnostic Radiology Physician
  • Indian Wells, CA
  • NPI 1114927050
  Medicare reassignment Care Compare group NPD
• Steven R Gunberg, D.O.

  • Diagnostic Radiology Physician
  • Beverly Hills, CA
  • NPI 1902817810

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Patricia Hadley, M.D.

  • Diagnostic Radiology Physician
  • Redding, CA
  • NPI 1750393633
  Medicare reassignment Care Compare group NPD
• Christopher Rigas Hancock, M.D.

  • Diagnostic Radiology Physician
  • Palm Desert, CA
  • NPI 1922128255
  Medicare reassignment Care Compare group NPD
• Andrew Burthe Harris, M.D.

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1174563399
  Medicare reassignment Care Compare group NPD
• Craig S Letner, M.D.

  • Diagnostic Radiology Physician
  • Chico, CA
  • NPI 1477516805
  Medicare reassignment Care Compare group NPD
• Robert O Lindsey, M.D.

  • Diagnostic Radiology Physician
  • Long Beach, CA
  • NPI 1578524468
  Medicare reassignment Care Compare group NPD
• Nghi Lu, M.D.

  • Diagnostic Radiology Physician
  • Riverside, CA
  • NPI 1235467143

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Arian Edwin Mashhood, M.D.

  • Neuroradiology Physician
  • Palo Alto, CA
  • NPI 1629411061
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1467506451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841163",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900841163",
            "telephone_number": "760-776-8989",
            "fax_number": "760-779-8073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74785 US HIGHWAY 111",
            "address_2": "SUITE 101",
            "city": "INDIAN WELLS",
            "state": "CA",
            "postal_code": "922107128",
            "telephone_number": "760-776-8989",
            "fax_number": "760-501-0311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18400 US Highway 18 Ste A",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923072306",
            "country_code": "US",
            "telephone_number": "760-242-3939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1133 N Palm Canyon Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922624431",
            "country_code": "US",
            "telephone_number": "760-322-8883",
            "fax_number": "760-501-0996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "81800 Doctor Carreon Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Indio",
            "state": "CA",
            "postal_code": "922015595",
            "country_code": "US",
            "telephone_number": "760-863-4085",
            "fax_number": "760-501-0081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "57370 29 Palms Hwy Ste 203",
            "address_purpose": "LOCATION",
            "city": "Yucca Valley",
            "state": "CA",
            "postal_code": "922842900",
            "country_code": "US",
            "telephone_number": "760-369-0069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1401 Avocado Ave Ste 608",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926608719",
            "country_code": "US",
            "telephone_number": "949-640-2081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "72650 Fred Waring Dr Ste 106",
            "address_purpose": "LOCATION",
            "city": "Palm Desert",
            "state": "CA",
            "postal_code": "922605007",
            "country_code": "US",
            "telephone_number": "760-230-9990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 N Indian Canyon Dr",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922624875",
            "country_code": "US",
            "telephone_number": "760-610-8650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "79440 Corporate Center Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "LA Quinta",
            "state": "CA",
            "postal_code": "922537243",
            "country_code": "US",
            "telephone_number": "760-346-1133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "72650 Fred Waring Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Palm Desert",
            "state": "CA",
            "postal_code": "922605007",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HALO MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "760-776-8989"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "FNP25453",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "ZZZ02402Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "ZZZ02402Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "ZZZ64094Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "ZZZ64094Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083072",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083073",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK9031",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "ZZZ57290Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "ZZZ05859Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "ZZZ57290Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083070",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083071",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "ZZZ05859Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DESERT MEDICAL IMAGING",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DESERT MEDICAL IMAGING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jullissa Marie Garza
• Kara Geno, APN
• Marianne Gregorich, FNP
• Michael Joseph Groban, M.D.
• Frank Warren Gustafson, RPT
• Mohammad Hishmeh, DDS
• HMG Urology PC
• Indian Wells Medical Center
• Indian Wells Psychiatry & Counseling Center Inc.
• Melissa Judnich, DPT

• Diagnostic Radiology Physician in Indian Wells, CA
• Providers in Indian Wells, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.