Individual provider Active NPI

Robert Brooke Summerour, MD

  • Psychiatry Physician
  • Riverside, CA
National Provider Identifier
1811085160
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G22962 Issued in CA
Practice address
5887 Brockton Ave
Suite a Riverside Psychiatric Medical Group
Riverside, CA 92506
Phone
(951) 275-8500
Fax
(951) 275-8560
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G22962 CA Primary

Addresses

Primary practice location

5887 Brockton Ave
Suite a Riverside Psychiatric Medical Group
Riverside, CA 92506

Mailing address

5887 Brockton Ave
Suite a Riverside Psychiatric Medical Group
Riverside, CA 92506
Phone (951) 275-8500

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
I20090130000167 CA Practitioner - Psychiatry 7810807682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Loma Linda University School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Riverside Psychiatric Medical GroupGroup PAC ID 8426956954, 8 clinicians

Practice addresses (Care Compare)

5887 Brockton Ave
Suite a
Riverside, CA 92506-1858
Phone (951) 275-8500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G22962CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Psychiatric Medical Group CurrentSince Jun 1, 1980 Accepting new patients

Locations

5887 Brockton Ave
Ste A
Riverside, CA 92506
Phone (909) 275-8500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1811085160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5887 BROCKTON AVE",
            "address_2": "SUITE A RIVERSIDE PSYCHIATRIC MEDICAL GROUP",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92506",
            "telephone_number": "951-275-8500",
            "fax_number": "951-275-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5887 BROCKTON AVE",
            "address_2": "SUITE A RIVERSIDE PSYCHIATRIC MEDICAL GROUP",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92506",
            "telephone_number": "951-275-8500",
            "fax_number": "951-275-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMEROUR",
        "first_name": "ROBERT",
        "middle_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G22962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.