Individual provider Active NPI

Derrick Raptis, M.D.

  • Pulmonary Disease Physician
  • Pomona, CA
National Provider Identifier
1679749683
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A117405 Issued in CA
Practice address
1940 N Orange Grove Ave Ste a
Pomona, CA 91767-3002
Phone
(909) 865-6900
Fax
(909) 865-6300
NPI assigned
Apr 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A117405 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 249226 NY
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A117405 CA
Pulmonary Disease Physician 207RP1001X 249226 NY
Pulmonary Disease Physician 207RP1001X A117405 CA Primary

Addresses

Primary practice location

1940 N Orange Grove Ave Ste a
Pomona, CA 91767-3002

Mailing address

840 Towne Center Dr
Pomona, CA 91767-5900
Phone (909) 398-1550

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
I20120316000326 CA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 9931368545 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chaparral Medical Group IncGroup PAC ID 6800709403, shared by 2 NPIs, 66 clinicians

Practice addresses (Care Compare)

1940 N Orange Grove Ave
Pomona, CA 91767-3002
Phone (909) 865-6900

8330 Red Oak St
Suite 201
Rancho Cucamonga, CA 91730-0603
Phone (909) 987-2528

Hospital & facility affiliations

  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231
  • San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

Merit-based Incentive Payment System (MIPS)

Final score
78.08 of 100Reported as group
Quality
40.87
Promoting interoperability
75
Improvement activities
40
Cost
74.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
249226NYMDCritical Care Medicine (Internal Medicine) Physician
A117405CAMDPulmonary Disease Physician

Practice roles (14 of 15)

OrganizationSpecialtyStatusNew patients
Chaparral Medical Group Inc. CurrentSince Jan 2, 2012 Accepting new patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients
Chaparral Medical Group, Inc. Current Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Chaparral Medical Group Inc Internal Medicine CurrentSince Jan 2, 2012 Accepting new patients
Chaparral Medical Group, Inc. Internal Medicine CurrentSince Jan 2, 2012 Accepting new patients
San Gorgonio Memorial Hospital Past Accepting new patients
Chaparral Medical Group Inc Internal Medicine Past Accepting new patients
Chino Medical Group, Inc Internal Medicine Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Yong Luke Lee Medical Corporation Past Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

1801 W Olympic Blvd
Pasadena, CA 91199

1940 N Orange Grove Ave
Pomona, CA 91767
Phone (909) 620-8443

1866 N Orange Grove Ave
Ste 202
Pomona, CA 91767
Phone (909) 623-8796

1940 N Orange Grove Ave
Ste B
Pomona, CA 91767
Phone (909) 620-1974

1940 N Orange Grove Ave
Ste A
Pomona, CA 91767
Phone (909) 629-0444

840 Towne Center Dr
Pomona, CA 91767

9190 Haven Ave
Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 581-6732

8330 Red Oak St
Ste 201
Rch Cucamonga, CA 91730
Phone (909) 987-1730

585 N Mountain Ave
Ste A
Upland, CA 91786
Phone (909) 608-7546

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 14

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 14

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1679749683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900",
            "telephone_number": "909-398-1550",
            "fax_number": "909-398-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 N ORANGE GROVE AVE STE A",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673002",
            "telephone_number": "909-865-6900",
            "fax_number": "909-865-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPTIS",
        "first_name": "DERRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A117405",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "249226",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A117405",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "249226",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A117405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.