Individual provider Active NPI

John Dax Lindo, MD

  • Child & Adolescent Psychiatry Physician
  • Riverside, CA
National Provider Identifier
1487947958
Registry record updated Sep 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
A142898 Issued in CA
Practice address
4095 County Circle Dr
Riverside, CA 92503-3410
Phone
(951) 358-4501
NPI assigned
May 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X A142898 CA Primary
Child & Adolescent Psychiatry Physician 2084P0804X 036.135917 IL

Addresses

Primary practice location

4095 County Circle Dr
Riverside, CA 92503-3410

Mailing address

PO Box 277
Bieber, CA 96009-0277
Phone (530) 294-5241

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
I20171026000402 CA Practitioner - Psychiatry 0749410496 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of RiversideGroup PAC ID 6507754488, 190 clinicians

Practice addresses (Care Compare)

1330 W Ramsey
Suite 100
Banning, CA 92220
Phone (951) 849-7142

940 E Williams St
Suite 102
Banning, CA 92220-5808
Phone (951) 849-6794

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A142898CAMDChild & Adolescent Psychiatry Physician
036.135917ILMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Valleys Health Centers CurrentSince Sep 26, 2017 Accepting new patients
Mountain Valleys Health Centers CurrentSince Sep 26, 2017 Accepting new patients
County of Riverside CurrentSince Apr 1, 2021 Accepting new patients
County of Riverside CurrentSince Apr 1, 2021 Accepting new patients
Mountain Valleys Health Centers Current Accepting new patients
County of Riverside Current Accepting new patients

Locations

3055 W Ramsey St
Banning, CA 92220
Phone (951) 358-5311

554-850 Medical Center Dr
Bieber, CA 96009
Phone (530) 294-5629

37491 Enterprise Dr
Burney, CA 96013
Phone (530) 335-5457

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73477
  • Direct secure messaging: jlindo256771@direct.llu.edu

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1487947958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "BIEBER",
            "state": "CA",
            "postal_code": "960090277",
            "telephone_number": "530-294-5241",
            "fax_number": "530-294-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4095 COUNTY CIRCLE DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033410",
            "telephone_number": "951-358-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDO",
        "first_name": "JOHN",
        "middle_name": "DAX",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-17",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A142898",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036.135917",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.