NPIMap

Organization Active NPI

Riverside Radiology Medical Group, Inc.

  • Vascular & Interventional Radiology Physician
  • Riverside, CA
National Provider Identifier
1790911964
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
RIVERSIDE RADIOLOGY MEDICAL GROUP, INC.
Practice address
4440 Brockton Ave
Suite 100
Riverside, CA 92501-4068
Phone
(951) 781-2277
Fax
(951) 781-2293
NPI assigned
Jun 2, 2009
Last updated
Jun 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2009

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

Authorized official

Name
Donald R. Massee, M.D.
Title
President
Phone
(951) 781-2277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X NU Primary

Addresses

Primary practice location

4440 Brockton Ave
Suite 100
Riverside, CA 92501-4068

Mailing address

PO Box 15648
Sacramento, CA 95852-0648
Phone (951) 781-2277

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": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1790911964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15648",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958520648",
            "telephone_number": "951-781-2277",
            "fax_number": "951-781-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 BROCKTON AVE",
            "address_2": "SUITE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014068",
            "telephone_number": "951-781-2277",
            "fax_number": "951-781-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE RADIOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "MASSEE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-781-2277",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "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 Jun 2, 2009; 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.