Individual provider Active NPI

Vicki Portnoff, M.D.

  • Diagnostic Radiology Physician
  • Indian Wells, CA
National Provider Identifier
1518910264
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G23464 Issued in CA
Practice address
77714 Cove Pointe Cir
Indian Wells, CA 92210-6101
Phone
(760) 219-6929
NPI assigned
May 17, 2006
Last updated
Mar 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G23464 CA Primary

Addresses

Primary practice location

77714 Cove Pointe Cir
Indian Wells, CA 92210-6101

Mailing address

77714 Cove Pointe Cir
Indian Wells, CA 92210-6101
Phone (760) 219-6929

Other identifiers 2

IdentifierTypeStateIssuer
00G234640OtherCABLUE SHIELD
00G234640MedicaidCA

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
I20040507001166 CA Practitioner - Diagnostic Radiology 8224027081 Reassigns benefits to 13 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, Irvine, California College of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Advanced Imaging Medical CenterGroup PAC ID 6406749613, 209 clinicians

Practice addresses (Care Compare)

1100 N Tustin Ave
Suite a
Santa Ana, CA 92705-3509
Phone (714) 835-6055

11525 Brookshire Ave
Suite 111
Downey, CA 90241-4982
Phone (562) 904-1111

12370 Hesperia Rd
Suite 15
Victorville, CA 92395-5808
Phone (760) 553-7000

16130 Ventura Blvd
Suite 100
Encino, CA 91436-2517
Phone (818) 933-2020

1821 W Olive Ave
Burbank, CA 91506-2435
Phone (818) 841-8880

18523 Corwin Rd
Suite J
Apple Valley, CA 92307-2300
Phone (760) 242-4444

18785 Brookhurst St
Suite 102
Fountain Valley, CA 92708-7300
Phone (714) 417-9950

23961 Calle de la Magdalena
Suite 243
Laguna Hills, CA 92653-3600
Phone (949) 272-2202

25395 Hancock Ave
Suite 110
Murrieta, CA 92562-9054
Phone (951) 696-4230

25775 McBean Pkwy
Suite 100
Valencia, CA 91355-3702
Phone (661) 255-7627

25800 Bob Hope Dr
Suite 255
Ranco Mirage, CA 92270-1739
Phone (760) 346-6239

2601 E Tahquitz Canyon Way
Palm Springs, CA 92262-7015
Phone (760) 318-2980

2679 Zoe Ave
Huntington Park, CA 90255-4144
Phone (323) 584-3333

2708 E Willow St
Signal Hill, CA 90755-2217
Phone (562) 216-5120

275 N Cielo Rd
Palm Springs, CA 92262-6972

275 N El Cielo Rd
Palm Springs, CA 92262-6972
Phone (760) 318-1934

3055 Wilshire Blvd
Suite 150
Los Angeles, CA 90010-1118
Phone (213) 487-4077

31565 Rancho Pueblo Rd
Suite 101
Temecula, CA 92592-4839
Phone (951) 302-2225

31775 De Portola Rd
Temecula, CA 92592-2742
Phone (951) 238-6070

3320 N Los Coyotes Diagonal
Suite 120
Long Beach, CA 90808-3936
Phone (562) 627-0903

3715 E S St
Long Beach, CA 90805-4521
Phone (562) 602-0700

40700 California Oaks Rd
Suite 103
Murrieta, CA 92562-5789
Phone (951) 894-4418

44105 15TH St W
Suite 100
Lancaster, CA 93534-4090
Phone (661) 726-6700

4500 Olivewood Ave
Suite 100200
Riverside, CA 92501-4116
Phone (951) 682-7580

490 Paulette PL
La Canada, CA 91011-2728
Phone (585) 218-8005

Merit-based Incentive Payment System (MIPS)

Final score
91.25 of 100Reported as group
Quality
75
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.25 of 100Reported as group
Quality
75
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G23464CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norcal Imaging Diagnostic Radiology CurrentSince Jan 23, 2018 Accepting new patients
Stockton Diagnostic Imaging Diagnostic Radiology CurrentSince Dec 15, 2017 Accepting new patients
Norcal Imaging Diagnostic Radiology CurrentSince Jan 23, 2018 Accepting new patients
Pronet Imaging Medical Group, Inc. Diagnostic Radiology CurrentSince Dec 15, 2017 Accepting new patients
Radnet Medical Imaging-San Francisco Diagnostic Radiology CurrentSince Dec 15, 2017 Accepting new patients
Desert Advanced Imaging Medical Center Diagnostic Radiology CurrentSince Jan 6, 2014 Accepting new patients
Fresno Imaging Center Diagnostic Radiology CurrentSince Jan 1, 2014 Accepting new patients
Santa Rosa Imaging Medical Center Diagnostic Radiology CurrentSince Dec 15, 2017 Accepting new patients
Diagnostic Radiological Imaging Diagnostic Radiology CurrentSince Dec 15, 2017 Accepting new patients
Modesto Advanced Diagnostic Imaging Medical Center Diagnostic Radiology CurrentSince Dec 15, 2017 Accepting new patients
San Fernando Valley Interventional Radiology and Imaging Center CurrentSince Dec 15, 2017 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Dec 1, 2005 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Dec 1, 2005 Accepting new patients
Quantum Medical Radiology PC Diagnostic Radiology Past Accepting new patients
Kern Radiology Medical Group, Inc Diagnostic Radiology Past Accepting new patients
South Coast Radiological Medical Group Inc Diagnostic Radiology Past Accepting new patients

Locations (25 of 42)

18523 Corwin Rd
Ste J
Apple Valley, CA 92307
Phone (760) 242-4444

8750 Wilshire Blvd
Ste 100
Beverly Hills, CA 90211
Phone (310) 689-3100

2601 W Alameda Ave
Ste 101
Burbank, CA 91505
Phone (818) 843-7462

2250 S Main St
Ste 103
Corona, CA 92882
Phone (951) 340-0340

801 S Main St
Ste 101
Corona, CA 92882
Phone (951) 682-1099

801 S Main St
Ste 205
Corona, CA 92882
Phone (951) 351-1025

886 Magnolia Ave
Ste 101
Corona, CA 92879
Phone (951) 340-4823

16130 Ventura Blvd
Ste 100
Encino, CA 91436
Phone (818) 933-2020

16311 Ventura Blvd
Ste 120
Encino, CA 91436
Phone (818) 817-7707

2201 Walnut Ave
Ste 150
Fremont, CA 94538
Phone (510) 713-1234

6107 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-4433

6191 N Thesta St
Fresno, CA 93710
Phone (559) 435-7200

9191 Westminster Ave
Ste 105
Garden Grove, CA 92844
Phone (714) 583-6314

250 S 12th Ave
Hanford, CA 93230
Phone (559) 295-2450

2679 Zoe Ave
Huntington Park, CA 90255
Phone (323) 584-3333

81880 Doctor Carreon Blvd
Ste A102
Indio, CA 92201

11360 Mountain View Ave
Ste C
Loma Linda, CA 92354
Phone (909) 478-3300

3320 N Los Coyotes Diagonal
Ste 120
Long Beach, CA 90808
Phone (562) 627-0903

3715 E South St
Long Beach, CA 90805
Phone (562) 602-0700

1516 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2843

27168 Newport Rd
Ste B
Menifee, CA 92584
Phone (951) 566-5725

157 E Coolidge Ave
Modesto, CA 95350
Phone (209) 524-6800

25395 Hancock Ave
#1101112
Murrieta, CA 92562
Phone (951) 696-4230

25395 Hancock Ave
Ste 110
Murrieta, CA 92562
Phone (951) 696-4230

3909 Waring Rd
Ste Bc
Oceanside, CA 92056
Phone (760) 630-0014

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333065600000",
    "number": "1518910264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77714 COVE POINTE CIR",
            "city": "INDIAN WELLS",
            "state": "CA",
            "postal_code": "922106101",
            "telephone_number": "760-219-6929",
            "fax_number": "760-772-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77714 COVE POINTE CIR",
            "city": "INDIAN WELLS",
            "state": "CA",
            "postal_code": "922106101",
            "telephone_number": "760-219-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTNOFF",
        "first_name": "VICKI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G23464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G234640",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G234640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Wells, CA

Sources for this page

Verify at the official NPI Registry.