Individual provider Active NPI

Seema Mukadam

  • Student in an Organized Health Care Education/Training Program
  • Loma Linda, CA
National Provider Identifier
1922531110
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(909) 558-4074
NPI assigned
Apr 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A159621 CA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St
Gme Office Westerly Suite C
Loma Linda, CA 92354-2804
Phone (909) 558-4074

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
I20200522002436 CA Practitioner - Internal Medicine 8325469604 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Pennsylvania State University College of Medicine, 2017
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

  • Riverside University Health System-Medical Center Hospital, Moreno Valley, CA, CCN 050292

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
A159621CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside CurrentSince Apr 1, 2021 Accepting new patients
County of Riverside Current Accepting new patients
Riverside Faculty Medical Group Inc Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
County of Riverside CurrentSince Apr 1, 2021 Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: smukadam135581@direct.llu.edu

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1922531110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "GME OFFICE WESTERLY SUITE C",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKADAM",
        "first_name": "SEEMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A159621",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.