Individual provider Active NPI

Rony Dekermenjian, M.D.

  • Neurology Physician
  • Riverside, CA
National Provider Identifier
1972766657
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A120917 Issued in CA
Practice address
4445 Magnolia Ave
Riverside, CA 92501-4135
Phone
(951) 338-4910
Fax
(833) 996-0004
NPI assigned
Jul 3, 2008
Last updated
Oct 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Neurology Physician 2084N0400X A120917 CA Primary
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X 16024 NV

Addresses

Primary practice location

4445 Magnolia Ave
Riverside, CA 92501-4135

Mailing address

700 E Redlands Blvd # 714
Redlands, CA 92373-6109
Phone (951) 338-4910

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
I20140507001123 CA Practitioner - NeurologyPractitioner - Sleep Medicine 1254564792 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Sleep Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cep America - Neurology PCGroup PAC ID 3971871500, 60 clinicians
California Neurointerventional Surgeons, IncGroup PAC ID 2668717125, 8 clinicians

Practice addresses (Care Compare)

31700 Temecula Pkwy
Temecula, CA 92592-5896
Phone (951) 331-2200

4445 Magnolia Ave
Riverside, CA 92501-4135
Phone (951) 338-4910

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16024NVMDNeuromuscular Medicine (Psychiatry & Neurology) Physician
A120917CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Neurology PC Neurology CurrentSince Jul 1, 2017 Accepting new patients
Cep America - Neurology PC Neurology Current Accepting new patients
California Neurointerventional Surgeons, Inc Neurology CurrentSince Oct 1, 2020 Accepting new patients
Cep America - Neurology PC Neurology CurrentSince Jul 1, 2017 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

625 S Fair Oaks Ave
Ste 325
Pasadena, CA 91105
Phone (626) 229-8969

700 E Redlands Blvd
Ste 714
Redlands, CA 92373

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

4445 Magnolia Ave
#1112
Riverside, CA 92501

400 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 569-7279

1805 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 877-6333

31700 Temecula Pkwy
Temecula, CA 92592
Phone (951) 303-8939

1115 S Sunset Ave
West Covina, CA 91790
Phone (626) 814-2434

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1972766657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E REDLANDS BLVD # 714",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736109",
            "telephone_number": "951-338-4910",
            "fax_number": "833-996-0004"
        },
        {
            "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": "951-338-4910",
            "fax_number": "833-996-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEKERMENJIAN",
        "first_name": "RONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A120917",
            "primary": true
        },
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "NV",
            "license": "16024",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.