NPIMap

Organization Active NPI

Riverside Radiology Medical Group Inc

  • Diagnostic Radiology Physician
  • Victorville, CA
National Provider Identifier
1679574594
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RIVERSIDE RADIOLOGY MEDICAL GROUP INC
Practice address
12276 Hesperia Rd
Ste 6
Victorville, CA 92395-5838
Phone
(760) 843-0995
Fax
(760) 843-0975
NPI assigned
Aug 2, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Jay Kerkar
Title
Ceo
Phone
(951) 781-2270

Specialties & licenses 1

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

Addresses

Primary practice location

12276 Hesperia Rd
Ste 6
Victorville, CA 92395-5838

Mailing address

PO Box 52499
Riverside, CA 92517-3499
Phone (951) 781-2270

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ751532MedicaidCA
CG9918OtherCANONE

National Provider Directory

National Provider Directory
Tax ID family
Riverside Radiology Medical Group Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679574594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52499",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925173499",
            "telephone_number": "951-781-2270",
            "fax_number": "951-787-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12276 HESPERIA RD",
            "address_2": "STE 6",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955838",
            "telephone_number": "760-843-0995",
            "fax_number": "760-843-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE RADIOLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KERKAR",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-781-2270",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ751532",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "CG9918",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.