NPIMap

Organization Active NPI

Desert Ear, Nose & Throat Medical Group, Inc.

  • Otolaryngology Physician
  • Rancho Mirage, CA
National Provider Identifier
1477513745
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
DESERT EAR, NOSE & THROAT MEDICAL GROUP, INC.
Practice address
71687 Highway 111 Ste 101
Rancho Mirage, CA 92270-4515
Phone
(760) 340-4566
Fax
(760) 340-2481
NPI assigned
Mar 23, 2006
Last updated
Jul 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Authorized official

Name
Dr. Christopher Walz, M.D.NPI 1205989514
Title
Partner/Delegated Official
Phone
(760) 340-4566

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X Primary
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0007X
Otology & Neurotology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0901X

Addresses

Primary practice location

71687 Highway 111 Ste 101
Rancho Mirage, CA 92270-4515

Mailing address

71687 Highway 111 Ste 101
Rancho Mirage, CA 92270-4515
Phone (760) 340-4566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070831000601 CA Part B Supplier - Clinic/Group Practice 6002909322 Receives reassigned benefits from 8 practitioners
Practice locations: Rancho Mirage, CA

National Provider Directory

National Provider Directory

Locations

39000 Bob Hope Dr
Ste W301
Rancho Mirage, CA 92270
Phone (760) 340-4566

71687 Highway 111
Ste 101
Rancho Mirage, CA 92270
Phone (760) 340-4566

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1477513745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71687 HIGHWAY 111 STE 101",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704515",
            "telephone_number": "760-340-4566",
            "fax_number": "760-340-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71687 HIGHWAY 111 STE 101",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704515",
            "telephone_number": "760-340-4566",
            "fax_number": "760-340-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT EAR, NOSE & THROAT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A",
        "authorized_official_last_name": "WALZ",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PARTNER/DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "760-340-4566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.