Active NPI
Samuel Ross Donnenfeld, MD
- Urology Physician
- Riverside, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- A202659
- Practice address
- 10800 Magnolia Ave
Riverside, CA 92505-3043 - Phone
- (091) 232-7106
- NPI assigned
- Apr 17, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Urology Physician | 208800000X | A202659 | CA | Primary |
Addresses
Primary practice location
10800 Magnolia Ave
Riverside, CA 92505-3043
Mailing address
1642 7TH Ave Unit 523
San Diego, CA 92101-2755
Phone (610) 937-8560
Other practice location 1
1365 Clifton Rd NE Ste B6140
Atlanta, GA 30322-1013
Phone (404) 778-4615
Other practice location 2
1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 712-2000
Other practice location 3
5673 Peachtree Dunwoody Rd Ste 350
Atlanta, GA 30342-5048
Phone (404) 778-4898
Other practice location 4
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- University of Utah School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-2000
27300 Iris Ave
Moreno Valley, CA 92555-4802
Phone (951) 243-0811
27350 Iris Ave
Moreno Valley, CA 92555-4802
Phone (866) 984-7483
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A202659 | CA | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Multi-Specialty | Current | Accepting new patients |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000
Organizations & group practices 2
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.
-
- Health Maintenance Organization
- Riverside, CA
- NPI 1316979834
Multi-Specialty
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753920000000",
"number": "1760045504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1642 7TH AVE UNIT 523",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921012755",
"telephone_number": "610-937-8560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10800 MAGNOLIA AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925053043",
"telephone_number": "091-232-7106"
}
],
"practiceLocations": [
{
"address_1": "1365 Clifton Rd NE Ste B6140",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303221013",
"country_code": "US",
"telephone_number": "404-778-4615",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1365 Clifton Rd NE",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303221013",
"country_code": "US",
"telephone_number": "404-712-2000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5673 Peachtree Dunwoody Rd Ste 350",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303425048",
"country_code": "US",
"telephone_number": "404-778-4898",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "80 Jesse Hill Jr Dr SE",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303033031",
"country_code": "US",
"telephone_number": "404-616-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DONNENFELD",
"first_name": "SAMUEL",
"middle_name": "ROSS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-17",
"last_updated": "2025-07-31",
"certification_date": "2025-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Urology",
"state": "CA",
"license": "A202659",
"primary": true
}
],
"identifiers": [],
"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 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.