Organization Active NPI

High Desert Internal Medicine, Professional Corporation

Doing business as High Desert Internal Medicine

  • Internal Medicine Physician
  • Hesperia, CA
National Provider Identifier
1851141139
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HIGH DESERT INTERNAL MEDICINE, PROFESSIONAL CORPORATION
Doing business as
High Desert Internal Medicine
Practice address
12765 Main St Ste 630
Hesperia, CA 92345-9134
Phone
(760) 995-2099
NPI assigned
Mar 27, 2024
Last updated
Sep 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Authorized official

Name
Ruby Jhaj, MDNPI 1962841940
Title
President
Phone
(805) 813-6851

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
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

12765 Main St Ste 630
Hesperia, CA 92345-9134

Mailing address

11133 Martingale Way
Rancho Cucamonga, CA 91737-1818
Phone (805) 813-6851

Other names 1

  • High Desert Internal Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241014001027 CA Part B Supplier - Clinic/Group Practice 9739611955 Receives reassigned benefits from 2 practitioners
Practice locations: Hesperia, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2307302High Desert Internal Medicine12765 Main St #630, Hesperia, CA 92345Certificate of waiverJul 4, 2026

National Provider Directory

National Provider Directory

Locations

12765 Main St
Hesperia, CA 92345

12765 Main St
Ste 630
Hesperia, CA 92345
Phone (760) 995-2099

Practitioners & affiliated clinicians

Practitioners 2

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": "1711497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1851141139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11133 MARTINGALE WAY",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917371818",
            "telephone_number": "805-813-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12765 MAIN ST STE 630",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923459134",
            "telephone_number": "760-995-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH DESERT INTERNAL MEDICINE, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "JHAJ",
        "authorized_official_first_name": "RUBY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-813-6851",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "High Desert Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hesperia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.