MISSION GROVE MEDICAL CORPORATION
NPI 1205224417
Internal Medicine - Pulmonary Disease in Riverside, CA
About Mission Grove Medical Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MISSION GROVE MEDICAL CORPORATION (NPI 1205224417), doing business as Urgent Care Clinic, is a healthcare organization registered as a pulmonary disease in Riverside, California and active in the NPI registry since December 2014. The organization lists Sibonisiwe Moyo Johnson, Ao, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mission Grove Medical Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Mission Grove Medical Corporation, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Mission Grove Medical Corporation's NPI number?
The NPI number for Mission Grove Medical Corporation is 1205224417. It was assigned to this organization in the NPPES registry on December 23, 2014. The provider is doing business as Urgent Care Clinic.
Where is Mission Grove Medical Corporation located?
Mission Grove Medical Corporation is located at 191 E Alessandro Blvd # 9A, Riverside, CA 92508. The listed phone number is (951) 780-3300.
What is Mission Grove Medical Corporation's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.
Is Mission Grove Medical Corporation enrolled in Medicare?
Yes. Mission Grove Medical Corporation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mission Grove Medical Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 2 Medicare specialties reassign their Medicare billing to Mission Grove Medical Corporation. 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. The largest specialties are Nurse Practitioner (7) and Pulmonary Disease (1). Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Mission Grove Medical Corporation was last updated on September 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 60 days 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.
# Mission Grove Medical Corporation · NPI 1205224417
Pulmonary Disease organization in Riverside, California. Organization record, active in the CMS NPPES registry since December 23, 2014.
## Identity
- **NPI:** 1205224417 (Entity type: Organization)
- **Enumerated:** December 23, 2014
- **Primary specialty:** Internal Medicine - Pulmonary Disease · taxonomy 207RP1001X
- **Also known as:** URGENT CARE CLINIC (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Sibonisiwe Johnson, AO
## Practice location
- **Address:** 191 E ALESSANDRO BLVD # 9A, Riverside, CA 92508-5095
- **Phone:** (951) 780-3300 · **Fax:** (951) 780-3303
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 8 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (7), Pulmonary Disease (1); 3 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 8, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1205224417) · Data from the CMS NPPES public registry.