Individual provider Active NPI

Pilar J Condry, M.D.

  • Pediatric Adolescent Medicine Physician
  • Moreno Valley, CA
National Provider Identifier
1669563748
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
A044231 Issued in CA
Practice address
14114 Business Center Dr
Suite B
Moreno Valley, CA 92553-9113
Phone
(951) 697-5777
Fax
(951) 697-5780
NPI assigned
Sep 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X A044231 CA Primary

Addresses

Primary practice location

14114 Business Center Dr
Suite B
Moreno Valley, CA 92553-9113

Mailing address

14114 Business Center Dr
Suite B
Moreno Valley, CA 92553-9113
Phone (951) 697-5777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A044231CAMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pilar J Condry, MD,Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pilarcondry@pjcmdi.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669563748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14114 BUSINESS CENTER DR",
            "address_2": "SUITE B",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925539113",
            "telephone_number": "951-697-5777",
            "fax_number": "951-697-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14114 BUSINESS CENTER DR",
            "address_2": "SUITE B",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925539113",
            "telephone_number": "951-697-5777",
            "fax_number": "951-697-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDRY",
        "first_name": "PILAR",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "A044231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.