RADIANT ADULT MEDICAL GROUP
NPI 1255976403
Nurse Practitioner - Family in Yuma, AZ
About Radiant Adult Medical Group NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RADIANT ADULT MEDICAL GROUP (NPI 1255976403) is a healthcare organization registered as a family in Yuma, Arizona and active in the NPI registry since November 2019. The organization holds a CLIA Waiver certificate valid through August 14, 2027 and lists Jennivyr Derakhshan, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
Radiant Adult Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Radiant Adult Medical Group, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
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 03D2287482
Radiant Adult Medical Group · Yuma, AZFrequently 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 Bjd Inc's NPI number?
The NPI number for Bjd Inc is 1255976403. It was assigned to this organization in the NPPES registry on November 12, 2019. The provider is doing business as Radiant Adult Medical Group.
Where is Bjd Inc located?
Bjd Inc is located at 1025 W 24th St Ste 26, Yuma, AZ 85364. The listed phone number is (928) 318-6910.
What is Bjd Inc's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Bjd Inc enrolled in Medicare?
Yes. Bjd Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Bjd Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Bjd Inc. 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, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Bjd Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 03D2287482) is associated with this NPI, valid through August 14, 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 Bjd Inc was last updated on September 13, 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.
# Radiant Adult Medical Group · NPI 1255976403
Family organization in Yuma, Arizona. Organization record, active in the CMS NPPES registry since November 12, 2019.
## Identity
- **NPI:** 1255976403 (Entity type: Organization)
- **Enumerated:** November 12, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Legal business name:** Bjd Inc
- **Organization subpart:** No
- **Authorized official:** Jennivyr Derakhshan, PRESIDENT
## Practice location
- **Address:** 1025 W 24TH ST STE 26, Yuma, AZ 85364-8372
- **Phone:** (928) 318-6910 · **Fax:** (928) 328-1056
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 13, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1255976403) · Data from the CMS NPPES public registry.