NPIMap

Organization Active NPI

Riverside Neurology Inc

  • Specialist
  • Riverside, CA
National Provider Identifier
1508059007
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
RIVERSIDE NEUROLOGY INC
Practice address
7172 Magnolia Ave
Riverside, CA 92504-3804
Phone
(951) 788-2224
Fax
(951) 788-5190
NPI assigned
Aug 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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

Authorized official

Name
Mr. Waseem N Ibrahim, M.D.NPI 1346291374
Title
M.D.
Phone
(951) 788-2224

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X Primary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X A44002 CA

Addresses

Primary practice location

7172 Magnolia Ave
Riverside, CA 92504-3804

Mailing address

7172 Magnolia Ave
Riverside, CA 92504-3804
Phone (951) 788-2224

Other names 1

  • Waseem N Ibrahim MD Inc Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050223000964 CA Part B Supplier - Clinic/Group Practice 4486607033 Receives reassigned benefits from 7 practitioners
Practice locations: Riverside, CA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390521600000",
    "number": "1508059007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7172 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925043804",
            "telephone_number": "951-788-2224",
            "fax_number": "951-788-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7172 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925043804",
            "telephone_number": "951-788-2224",
            "fax_number": "951-788-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE NEUROLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-20",
        "last_updated": "2014-01-24",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "WASEEM",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "951-788-2224",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A44002",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waseem N Ibrahim MD Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; 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.