NPIMap

Organization Active NPI

Westside Medical Group Inc

  • Rural Health Clinic/Center
  • Firebaugh, CA
National Provider Identifier
1831235605
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WESTSIDE MEDICAL GROUP INC
Practice address
1107 O St
Firebaugh, CA 93622-2224
Phone
(559) 659-9000
Fax
(559) 659-9017
NPI assigned
Jan 29, 2007
Last updated
Jan 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Authorized official

Name
Jaspreet K Riar, PA-CNPI 1184719460
Title
Owner
Phone
(559) 659-9000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

1107 O St
Firebaugh, CA 93622-2224

Mailing address

1107 O St
Firebaugh, CA 93622-2224
Phone (559) 659-9000

Other identifiers 1

IdentifierTypeStateIssuer
RHM53929FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081014000274 CA Part A Provider - Rural Health Clinic 8921176272 Practice locations: Firebaugh, CA
O20200721002081 CA Part B Supplier - Clinic/Group Practice 8921176272 Receives reassigned benefits from 3 practitioners
Practice locations: Firebaugh, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831235605. Details of each certification follow.

Rural health clinic certification: CCN 553929

Legal name
WESTSIDE MEDICAL GROUP INC
Doing business as
WESTSIDE MEDICAL GROUP
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 26, 2000
Last certification
May 16, 2018
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Jan 25, 2000 in CA
Enrollment address
1107 O St
Firebaugh, CA 93622-2224

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Dennis Keith Miller Individual Contracted Managing EmployeeMedical Director Jan 1, 2023
5% Or Greater Direct Ownership Interest Jan 1, 2023 51%
Corporate Officer Jan 1, 2023
Corporate Director Jan 1, 2023
Operational/Managerial ControlMedical Director Jan 1, 2023
Jaspreet K Riar Individual 5% Or Greater Direct Ownership Interest Jan 1, 2023 49%
Corporate Officer Jan 1, 2023
Corporate Director Jan 1, 2023
W-2 Managing EmployeeCeo/Cfo Jan 1, 2023
Operational/Managerial ControlCeo/Cfo Jan 1, 2023

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Dennis Keith Miller, D.O.
    • Family Medicine Physician
    • Hanford, CA
    • NPI 1487893483

    5% Or Greater Direct Ownership Interest, Contracted Managing Employee, Corporate Director, Corporate Officer, Operational/Managerial Control

    CMS ownership
  • Jaspreet K Riar, PA-C
    • Physician Assistant
    • Firebaugh, CA
    • NPI 1184719460

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1831235605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 O ST",
            "city": "FIREBAUGH",
            "state": "CA",
            "postal_code": "936222224",
            "telephone_number": "559-659-9000",
            "fax_number": "559-659-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 O ST",
            "city": "FIREBAUGH",
            "state": "CA",
            "postal_code": "936222224",
            "telephone_number": "559-659-9000",
            "fax_number": "559-659-9017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A",
        "authorized_official_last_name": "RIAR",
        "authorized_official_first_name": "JASPREET",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-659-9000",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM53929F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Firebaugh, CA

Sources for this page

Verify at the official NPI Registry.