Jerry I Nam, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

J6616 Issued in TX

Practice address

4445 Magnolia Ave
Riverside, CA 92501-4135

Phone

(951) 788-3400

Fax

(979) 774-7871

NPI assigned

Apr 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, CA2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Baylor College of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bryan Radiology AssociatesGroup PAC ID 4880598143, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011
• Columbus Community Hospital Hospital, Columbus, TX, CCN 450370
• Aspire Hospital Hospital, Conroe, TX, CCN 670093
• Physicians Centre,the Hospital, Bryan, TX, CCN 450834
• Burleson St Joseph Health Center Hospital, Caldwell, TX, CCN 451305

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Bryan Radiology Associates

  • Diagnostic Radiology Physician
  • Bryan, TX
  • NPI 1992731178
  Medicare reassignment Care Compare group NPD
• Bryan Radiology Associates

  • Diagnostic Radiology Physician
  • Bryan, TX
  • NPI 1457651341
  NPD (past)

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

• Aspire Hospital, LLC

  • Psychiatric Hospital
  • Conroe, TX
  • NPI 1093955296
  Care Compare affiliation
• Aspire Hospital, LLC

  • General Acute Care Hospital
  • Conroe, TX
  • NPI 1114340080
  Care Compare affiliation
• Brazos Valley Physicians Organization,Mso-LLC

  dba The Physicians Pain and Spine Centre

  • General Acute Care Hospital
  • Bryan, TX
  • NPI 1801817135
  Care Compare affiliation
• Burleson Lease Corp

  • Critical Access Hospital
  • Caldwell, TX
  • NPI 1568548683
  Care Compare affiliation
• Burleson St. Joseph Health Center of Caldwell, Texas

  • Critical Access Hospital
  • Caldwell, TX
  • NPI 1750377289
  Care Compare affiliation
• Columbus Community Hospital

  • Rural Acute Care Hospital
  • Columbus, TX
  • NPI 1740238641
  Care Compare affiliation
• St Joseph Regional Health Center

  • General Acute Care Hospital
  • Bryan, TX
  • NPI 1942294939
  Care Compare affiliation
• St. Joseph Regional Health Center

  dba CHI St. Joseph Health College Station Hospital

  • General Acute Care Hospital
  • College Station, TX
  • NPI 1053963009
  Care Compare affiliation

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1972565000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014135",
            "telephone_number": "951-788-3400",
            "fax_number": "951-788-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014135",
            "telephone_number": "951-788-3400",
            "fax_number": "979-774-7871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "JERRY",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "TX",
            "license": "J6616",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "J6616",
            "primary": true
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "A65698",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118679302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelyn Nakama-Domantay
• Hrach Mark Nalchajyan, DO
• Bongkyu Nam, LAC
• Il Woo Nam, DDS
• Jennifer Nam
• Barbara Milbert Namayanja
• Amanda Catherine Nambar
• Namg Home Dialysis LLC (Riverside PD Central)
• Namg Home Dialysis LLC (Magnolia West At Home)
• Namg Riverside ASC LLC

• Diagnostic Radiology Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.