NPIMap

Organization Active NPI

Riverside Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Redlands, CA
National Provider Identifier
1700252467
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A112768 Issued in CA
Legal business name
RIVERSIDE RADIOLOGY MEDICAL GROUP, INC.
Practice address
30700 E Sunset Dr S
Redlands, CA 92373-7448
Phone
(310) 717-0360
Fax
(770) 666-9102
NPI assigned
Aug 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Authorized official

Name
Dr. Donald Massee, M.D.
Title
President
Phone
(951) 781-2273

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X A112768 CA Primary

Addresses

Primary practice location

30700 E Sunset Dr S
Redlands, CA 92373-7448

Mailing address

PO Box 511412
Los Angeles, CA 90051-7967
Phone (877) 441-9002

Other identifiers 1

IdentifierTypeStateIssuer
1194979856OtherCANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120509000724 CA Part B Supplier - Clinic/Group Practice 2365412327 Receives reassigned benefits from 36 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rancho Cucamonga, CA; Sacramento, CA; Redlands, CA; Riverside, CA; San Bernardino, CA; San Clemente, CA; Temple City, CA; Torrance, CA…

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1700252467",
    "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": "877-441-9002",
            "fax_number": "559-455-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30700 E SUNSET DR S",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923737448",
            "telephone_number": "310-717-0360",
            "fax_number": "770-666-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE RADIOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "MASSEE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-781-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A112768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1194979856",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.