Desert Valley Medical Group, Inc.
Organization Active NPI Family Medicine Physician · Adelanto, CA
NPI 1942250873 · NPPES record last updated Apr 27, 2020
Key facts
- NPI
- 1942250873
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- DESERT VALLEY MEDICAL GROUP, INC.
- Practice address
- 11499 Bartlett Ave
Adelanto, CA 92301-1902 - Phone
- (760) 241-8000
- NPI assigned
- May 11, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Kavitha Bhatia, MD
- Title
- Owner
- Phone
- (760) 241-8000
Other NPIs on the same Medicare enrollment 11
Practitioners 9
-
Tanaia Carmichael, FNP
-
Michelle Juat, MSN, APRN,FNP-BC
-
Bernice Pui Sim Kahkosko, FNP-BC
-
Stephany Salazar, NURSE PRACTITIONER
-
Randolph Salbino, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040113000803 | CA | Part B Supplier - Clinic/Group Practice | 4880595875 |
Receives reassigned benefits from 151 practitioners 11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Victorville, CA; Hesperia, CA; Chino, CA; Apple Valley, CA |
National Provider Directory
Locations
16850 Bear Valley Rd
Ste 100
Victorville, CA 92395
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Occupational Medicine Physician |
2083X0100X | |||
| General Practice Physician |
208D00000X |
Addresses
Primary practice location
11499 Bartlett Ave
Adelanto, CA 92301-1902
Mailing address
16850 Bear Valley Rd
Victorville, CA 92395-5794
Phone (760) 241-8000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0072097 | Medicaid | CA | |
| 4584430010 | Other | CA | DMERC |
| CC8406 | Other | CA | RAILROAD MEDICARE |
Other names
- Primecare Medical Group of Desert Valley, Inc.
Other providers in Adelanto, CA
- Natalie Contreras-Bermudez
- County of San Bernardino
- Thomas Augustus Cox II
- Darlenes L. H. Residential Care Inc
- Dependable Medical Supply
- Karen Colleen Dossey
- Dr Mikel Walk in Clinic
- Edizon Physical Therapy Inc.
- Emmanuel Unique Outreach Partners
- Cynthia Esquivel
All providers in Adelanto, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.