Individual provider Active NPI

Brandon Lee Nathaniel, MD

  • Hospitalist Physician
  • Moreno Valley, CA
National Provider Identifier
1851550834
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A112673 Issued in CA
Practice address
26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone
(951) 486-5700
Fax
(951) 486-5705
NPI assigned
Jun 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A112673 CA Primary

Addresses

Primary practice location

26520 Cactus Ave
Moreno Valley, CA 92555-3927

Mailing address

PO Box 7270
Moreno Valley, CA 92552-7270
Phone (951) 656-1500

Other identifiers 1

IdentifierTypeStateIssuer
CA124033OtherCAPTAN

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140723001293 CA Practitioner - HospitalistPractitioner - Internal Medicine 1557587896 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of California, Davis School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Faculty Medical Group IncGroup PAC ID 9436253515, 76 clinicians

Practice addresses (Care Compare)

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 656-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.34 of 100Reported as group
Quality
84.11
Promoting interoperability
96
Improvement activities
40
Cost
77.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
112673CAMDMarriage & Family Therapist
A112673CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside Current Accepting new patients
Riverside Faculty Medical Group Inc CurrentSince Jul 1, 2014 Accepting new patients
County of Riverside CurrentSince Jul 1, 2020 Accepting new patients
County of Riverside CurrentSince Jul 1, 2020 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Nov 1, 2016 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Nov 1, 2016 Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

26600 Cactus Ave
Ste 300
Moreno Valley, CA 92555
Phone (800) 720-9553

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Interoperability endpoints

  • Direct secure messaging: bnathaniel9628@direct.llu.edu

Organizations & group practices 7

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": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1851550834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7270",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925527270",
            "telephone_number": "951-656-1500",
            "fax_number": "951-656-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "951-486-5700",
            "fax_number": "951-486-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHANIEL",
        "first_name": "BRANDON",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-05",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A112673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "CA124033",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.