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Organization Active NPI

Riverside Radiology Medical Group Inc

  • Diagnostic Radiology Physician
  • Riverside, CA
National Provider Identifier
1699776526
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
4445 Magnolia Ave
Riverside, CA 92501-4135
Phone
(951) 788-3400
Fax
(951) 788-3194
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
Donal R. Massee, MD.
Title
President
Phone
(951) 781-2270

Specialties & licenses 1

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

Addresses

Primary practice location

4445 Magnolia Ave
Riverside, CA 92501-4135

Mailing address

PO Box 511412
Los Angeles, CA 90051-7967
Phone (877) 411-9002

Other identifiers 1

IdentifierTypeStateIssuer
GR0104280MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, FL, GA, CA, TX, TN, MO, MI, AZ, KS, NY, CO, IL, SC, PR, PA, KY, WA, WI, VI, NM, AL, OH, NJ24 enrollments

Enrollment records 24

Enrollment IDStateProvider typePAC IDDetails
O20110210000741 MA Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Concord, MA
O20110226000015 FL Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 8 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Lauderdale, FL; Weston, FL; Santa Rosa Beach, FL; Riviera Beach, FL; Pembroke Pines, FL; Pensacola Beach, FL; Highland Beach, FL; Miami, FL
O20120103000454 GA Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 2 practitioners
Practice locations: Washington, GA; Saint Marys, GA; Rome, GA; Atlanta, GA
O20120509000724 CA Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 36 practitioners
17 other NPIs on this enrollment
Practice locations: Rancho Cucamonga, CA; Sacramento, CA; Redlands, CA; Riverside, CA; San Bernardino, CA; San Clemente, CA; Temple City, CA; Torrance, CA…
O20131231001631 TX Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 7 practitioners
Practice locations: Prosper, TX; Webster, TX; Sugar Land, TX; Southlake, TX; Lubbock, TX; Houston, TX; Frisco, TX; Allen, TX
O20140415002346 TN Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 2 practitioners
Practice locations: Brentwood, TN; Franklin, TN; Nashville, TN
O20140514001882 MO Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 1 practitioner
Practice locations: Parkville, MO
O20160922001475 MI Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 3 practitioners
Practice locations: Ann Arbor, MI; Bloomfield Hills, MI; Milford, MI
O20180925002657 AZ Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 11 practitioners
Practice locations: Scottsdale, AZ; Queen Creek, AZ; Phoenix, AZ; Paradise Valley, AZ; Chandler, AZ; Cave Creek, AZ
O20181107002517 KS Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 2 practitioners
Practice locations: Mission, KS; Lawrence, KS
O20201112002975 NY Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 4 practitioners
Practice locations: East Setauket, NY; New York, NY; Plattsburgh, NY; Sag Harbor, NY
O20211230000474 CO Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 5 practitioners
Practice locations: Durango, CO; Cortez, CO; Lafayette, CO; Grand Junction, CO
O20230524002178 IL Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 3 practitioners
Practice locations: Western Springs, IL; Chicago, IL; Algonquin, IL
O20230525000292 SC Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 4 practitioners
Practice locations: Columbia, SC; North Augusta, SC; Simpsonville, SC
O20230526000007 PR Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 3 practitioners
Practice locations: San Juan, PR
O20230802000971 PA Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 2 practitioners
Practice locations: Gibsonia, PA; Bear Creek Township, PA
O20240313003636 KY Part B Supplier - Clinic/Group Practice 2365412327 Practice locations: Bowling Green, KY
O20240422001222 WA Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Forest Park, WA; Selah, WA
O20240603002949 WI Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 1 practitioner
Practice locations: Janesville, WI
O20240625004228 VI Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 1 practitioner
Practice locations: Frederiksted, VI
O20240718004904 NM Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 1 practitioner
Practice locations: Albuquerque, NM
O20241203003319 AL Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 1 practitioner
Practice locations: Vestavia Hills, AL
O20241203003850 OH Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 2 practitioners
Practice locations: Ottawa Hills, OH; Perrysburg, OH
O20250123003397 NJ Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 1 practitioner
Practice locations: Essex Fells, NJ

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory

Locations

1770 Iowa Ave
Riverside, CA 92507
Phone (951) 801-6348

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 98

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.

View all 98

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": "1699776526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511412",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900517967",
            "telephone_number": "877-411-9002",
            "fax_number": "559-455-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014135",
            "telephone_number": "951-788-3400",
            "fax_number": "951-788-3194"
        }
    ],
    "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": "MASSEE",
        "authorized_official_first_name": "DONAL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-781-2270",
        "authorized_official_credential": "MD."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0104280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 21, 2022; 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.