Individual provider Active NPI

Rishi Bommannan, MD

  • Emergency Medicine Physician
  • Riverside, CA
National Provider Identifier
1851040323
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A189650 Issued in CA
Practice address
4510 Brockton Ave Ste 223
Riverside, CA 92501-4020
Phone
(951) 788-3536
NPI assigned
Mar 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A189650 CA Primary

Addresses

Primary practice location

4510 Brockton Ave Ste 223
Riverside, CA 92501-4020

Mailing address

4510 Brockton Ave Ste 223
Riverside, CA 92501-4020
Phone (951) 788-3536

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
I20250617000943 CA Practitioner - Emergency Medicine 5496266488 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians Associates San Jose PCGroup PAC ID 8921344292, 131 clinicians

Practice addresses (Care Compare)

225 N Jackson Ave
San Jose, CA 95116-1603
Phone (408) 259-5000

Hospital & facility affiliations

  • Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A189650CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Jul 1, 2025 Accepting new patients
County of Santa Clara Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
County of Santa Clara Current Accepting new patients
Emergency Physicians Associates San Jose PC Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1851040323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 BROCKTON AVE STE 223",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014020",
            "telephone_number": "951-788-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 BROCKTON AVE STE 223",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014020",
            "telephone_number": "951-788-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMMANNAN",
        "first_name": "RISHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-22",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A189650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.