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TRIDENT MEDICAL GROUP INC.
NPI 1093498230
Internal Medicine in Apple Valley, CA

Active since August 14, 2023CLIA 05D2294635 · Waiver
18564 US HIGHWAY 18 STE 103&104, APPLE VALLEY, CA 92307(760) 242-9262 Get Directions Write a Review

NPPES record last updated: March 5, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 5, 2024, Aug 14, 2023 (2 updates tracked since 2023).

About Trident Medical Group Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRIDENT MEDICAL GROUP INC. (NPI 1093498230) is a healthcare organization registered as an internal medicine in Apple Valley, California and active in the NPI registry since August 2023. The organization holds a CLIA Waiver certificate valid through November 27, 2027 and lists Nyra Khetarpal, President, as its authorized official.

NPPES Registry Identity

NPI1093498230
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameTRIDENT MEDICAL GROUP INC.
Location Address18564 US HIGHWAY 18 STE 103&104Apple Valley, CA 92307-2312
Mailing Address14050 Riverside DrApple Valley, CA 92307-5335
Phone(760) 242-9262
Organization SubpartNo
Authorized OfficialNyra KhetarpalPresident · (484) 557-9511
Enumeration DateAugust 14, 2023
Last NPPES UpdateMarch 5, 20242 updates tracked since enumeration
NPPES CertifiedMarch 5, 2024
✔ NPI 1093498230 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
18564 US HIGHWAY 18 STE 103&104, Apple Valley, CA 92307
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Trident Medical Group Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Trident Medical Group Inc., which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Nyra Khetarpal, M.D.
Internal Medicine
NPI 1982999116
18564 US HIGHWAY 18 STE 103104
Apple Valley, CA 92307
(760) 242-9262
✔ PECOS✔ Accepts MedicareSame address
Maria Linnette Gutierrez, NURSE PRACTITIONER
Nurse Practitioner
NPI 1740179803
2625 TOWNSGATE RD STE 330
Westlake Village, CA 91361
(818) 575-6211
✔ PECOS94 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2294635

Trident Medical Center · Apple Valley, CA
Active · expires Nov 27, 2027
CLIA Number05D2294635
Laboratory TypePhysician Office
Certificate Effective DateNovember 28, 2025
Certificate Expiration DateNovember 27, 2027
Laboratory DirectorNyra Khetarpal
Laboratory Phone(484) 557-9511
Laboratory LocationTrident Medical Center18564 Us Highway 18 Ste 104, Apple Valley, CA 92307
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Trident Medical Group Inc.'s NPI number?

The NPI number for Trident Medical Group Inc. is 1093498230. It was assigned to this organization in the NPPES registry on August 14, 2023.

Where is Trident Medical Group Inc. located?

Trident Medical Group Inc. is located at 18564 Us Highway 18 Ste 103&104, Apple Valley, CA 92307. The listed phone number is (760) 242-9262.

What is Trident Medical Group Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Trident Medical Group Inc. enrolled in Medicare?

Yes. Trident Medical Group Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Trident Medical Group Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Trident Medical Group Inc., in Internal Medicine and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Trident Medical Group Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2294635) is associated with this NPI, valid through November 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Trident Medical Group Inc. was last updated on March 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.