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HERITAGE VICTOR VALLEY MEDICAL GROUP
NPI 1295126001
Clinic/Center in Victorville, CA

Active since February 16, 2015CLIA Certified · 7 labs
12370 HESPERIA RD, SUITE 6, VICTORVILLE, CA 92395(760) 245-4747(760) 245-4868 Get Directions Write a Review

NPPES record last updated: February 27, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Heritage Victor Valley Medical Group NPPES

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

HERITAGE VICTOR VALLEY MEDICAL GROUP (NPI 1295126001) is a healthcare organization registered as a clinic/center in Victorville, California and active in the NPI registry since February 2015. The organization holds 7 active CLIA laboratory certificates, maintains 5 additional practice locations, and lists Martha Paredes, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1295126001
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameVVIPA MEDICAL GROUP INC
Location Address12370 HESPERIA RD, SUITE 6Victorville, CA 92395-7719
Mailing AddressPo Box 7020Lancaster, CA 93539-7020 · (661) 726-3819 · Fax (661) 793-7025
Phone(760) 245-4747
Fax(760) 245-4868
Organization SubpartYesParent: Heritage Provider Network
Authorized OfficialMartha ParedesBilling Manager · (661) 726-3819
Enumeration DateFebruary 16, 2015
Last NPPES UpdateFebruary 27, 2024
NPPES CertifiedFebruary 27, 2024
✔ NPI 1295126001 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedPediatricsTaxonomy 208000000X
Also ListedSurgeryTaxonomy 208600000X
Also ListedGeneral PracticeTaxonomy 208D00000X
Also ListedHospitalistTaxonomy 208M00000X
12370 HESPERIA RD, Victorville, CA 92395
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Other Names 1

Doing Business AsHeritage Victor Valley Medical Group

Secondary Practice Locations 5

Location 1500 S 7th Ave Ste B&cBarstow, CA 92311-3056 · Phone (760) 256-1777 · Fax (760) 256-7766
Location 216003 Tuscola Rd Ste FApple Valley, CA 92307-0825 · Phone (760) 242-8221 · Fax (760) 242-8869
Location 342002 Fox Farm Rd Unit DBig Bear Lake, CA 92315-2190 · Phone (909) 878-8000 · Fax (909) 872-5203
Location 43936 Phelan Rd Ste F1Phelan, CA 92371-4174 · Phone (760) 868-6622 · Fax (760) 868-2505
Location 512408 Hesperia Rd Ste 2Victorville, CA 92395-4786 · Phone (760) 553-7000 · Fax (760) 269-1282

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Heritage Victor Valley Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

27

Medicare enrollment records show 27 clinicians reassign Medicare billing to Heritage Victor Valley Medical Group, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 10 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 8

Nurse Practitioner11
Family Practice7
Internal Medicine4
Cardiac Electrophysiology1
General Practice1
Obstetrics/Gynecology1
Optometry1
Pediatric Medicine1

Nearest to this location (20)

See all 27
Cheyenne Conway, DNP, FNP-C
Nurse Practitioner
NPI 1306520531
12370 HESPERIA RD STE 4
Victorville, CA 92395
(760) 245-4747
✔ PECOS✔ Accepts MedicareSame address
Roger Moushabek, M.D.
Internal Medicine
NPI 1073541157
12370 HESPERIA RD SUITE 6
Victorville, CA 92395
(760) 952-1222
✔ PECOS✔ Accepts MedicareSame address
Marlon Russell, M.D.
Internal Medicine
NPI 1497039119
12370 HESPERIA RD STE 15
Victorville, CA 92395
(760) 261-5292
✔ PECOS✔ Accepts MedicareSame address
Fadi Tahhan, DO
Internal Medicine
NPI 1477177798
12370 HESPERIA RD STE 15
Victorville, CA 92395
(760) 261-5292
✔ PECOS✔ Accepts MedicareSame address
Curtis Hoggarth, O.D.
Optometry
NPI 1134125321
12408 HESPERIA RD SUITE 7
Victorville, CA 92395
(760) 261-6422
✔ PECOS✔ Accepts MedicareSame address
Marina Youssef, FNP-BC
Nurse Practitioner
NPI 1730058496
12370 HESPERIA RD STE 15
Victorville, CA 92395
(760) 261-5292
✔ PECOS✔ Accepts Medicare0.1 mi
Sourav Das, MD
Family Practice
NPI 1174805279
13010 HESPERIA RD STE 501
Victorville, CA 92395
(442) 427-2441
✔ PECOS✔ Accepts Medicare0.8 mi
Janet Warren, NP
Nurse Practitioner
NPI 1467792051
19341 BEAR VALLEY RD STE 105
Apple Valley, CA 92308
(760) 241-6666
✔ PECOS✔ Accepts Medicare2.9 mi
Elsa Uresti, FNP-C
Nurse Practitioner
NPI 1164204061
18095 US HIGHWAY 18
Apple Valley, CA 92307
(760) 242-2333
✔ PECOS4.6 mi
Ziad Sawan, MD
General Practice
NPI 1912958786
16003 TUSCOLA RD SUITE F
Apple Valley, CA 92307
(760) 242-8221
✔ PECOS✔ Accepts Medicare4.7 mi
Aida Girma
Nurse Practitioner
NPI 1174227342
3936 PHELAN RD STE F1
Phelan, CA 92371
(760) 868-6622
✔ PECOS✔ Accepts Medicare17 mi
Rachel Ryan, NP-C
Nurse Practitioner
NPI 1366969867
3936 PHELAN RD STE F1
Phelan, CA 92371
(760) 868-6622
✔ PECOS✔ Accepts Medicare17 mi
Son Nguyen, M.D.
Family Practice
NPI 1376593889
2150 N WATERMAN AVE STE 202
San Bernardino, CA 92404
(909) 383-9385
✔ PECOS✔ Accepts Medicare24 mi
Elizabeth Pagler, M.D.
Family Practice
NPI 1295185254
11398 KENYON WAY STE J
Rancho Cucamonga, CA 91701
(909) 727-3911
✔ PECOS✔ Accepts Medicare28 mi
David Horner, MD
Family Practice
NPI 1407112923
42002 FOX FARM RD UNIT 200
Big Bear Lake, CA 92315
(909) 878-8000
✔ PECOS✔ Accepts Medicare28 mi
Kimberly Delandtsheer
Nurse Practitioner
NPI 1124711247
42002 FOX FARM RD
Big Bear Lake, CA 92315
(909) 878-8000
✔ PECOS✔ Accepts Medicare28 mi
Jeremy Lucero
Nurse Practitioner
NPI 1720660293
12347 CLAREDON DR UNIT 1
Rancho Cucamonga, CA 91739
(909) 912-2033
✔ PECOS✔ Accepts Medicare29 mi
Eloise Skelton, M.D.
Obstetrics/Gynecology
NPI 1285774661
500 S 7TH AVE STE D
Barstow, CA 92311
(760) 256-1777
✔ PECOS33 mi
Kenneth Terry, DO
Family Practice
NPI 1144712902
303 E BUENA VISTA ST
Barstow, CA 92311
(760) 241-4929
✔ PECOS33 mi
Amir Hedayati-Rad, M.D.
Cardiac Electrophysiology
NPI 1861410029
706 W BROADWAY # 100
Glendale, CA 91204
(818) 507-6404
✔ PECOS✔ Accepts Medicare60 mi
See all 27 clinicians

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 7

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 05D1073520

Heritage Victor Valley Medical Group - Apple Valley · Apple Valley, CA
Active · expires Mar 6, 2028
CLIA Number05D1073520
Laboratory TypePhysician Office
Certificate Effective DateMarch 7, 2026
Certificate Expiration DateMarch 6, 2028
Laboratory DirectorZiad R. Sawan
Laboratory Phone(760) 242-8221
Laboratory LocationHeritage Victor Valley Medical Group - Apple Valley16003 Tuscola Rd Ste F, Apple Valley, CA 92307
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D1087167

Heritage Victor Valley Medical Group - Phelan · Phelan, CA
Active · expires Jan 28, 2027
CLIA Number05D1087167
Laboratory TypePhysician Office
Certificate Effective DateJanuary 29, 2025
Certificate Expiration DateJanuary 28, 2027
Laboratory DirectorMarlon S. Russell MD
Laboratory Phone(760) 868-6622
Laboratory LocationHeritage Victor Valley Medical Group - Phelan3936 Phelan Rd Suite F1, Phelan, CA 92371
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 05D1084500

Heritage Victor Valley Medical Group · Victorville, CA
Active · expires Nov 30, 2026
CLIA Number05D1084500
Laboratory TypeUrgent Care/Physician Off
Certificate Effective DateMay 27, 2023
Certificate Expiration DateNovember 30, 2026
Laboratory DirectorMarlon Russell MD
Laboratory Phone(760) 261-5292
Laboratory LocationHeritage Victor Valley Medical Group12370 Hesperia Rd Ste 15 Attn Angela Mendoza (urgent Care Lab), Victorville, CA 92395
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 05D2030527

Heritage Victor Valley Med Grp Victorville Clinic · Victorville, CA
Active · expires Sep 28, 2027
CLIA Number05D2030527
Laboratory TypePhysician Office
Certificate Effective DateSeptember 29, 2025
Certificate Expiration DateSeptember 28, 2027
Laboratory DirectorPrakash Yakkundi
Laboratory Phone(760) 553-7000
Laboratory LocationHeritage Victor Valley Med Grp Victorville Clinic12408 Hesperia Road Ste. 2, Victorville, CA 92395
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2330991

Heritage Victor Valley Medical Group-Big Bear · Big Bear, CA
Active · expires Sep 23, 2027
CLIA Number05D2330991
Laboratory TypePhysician Office
Certificate Effective DateSeptember 24, 2025
Certificate Expiration DateSeptember 23, 2027
Laboratory DirectorDavid J. Horner
Laboratory Phone(909) 878-8000
Laboratory LocationHeritage Victor Valley Medical Group-Big Bear42002 Fox Farm #200, Big Bear, CA 92315
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2160430

Heritage Victor Valley Medical Group · Big Bear Lake, CA
Active · expires Jan 9, 2027
CLIA Number05D2160430
Laboratory TypePhysician Office
Certificate Effective DateJanuary 10, 2025
Certificate Expiration DateJanuary 9, 2027
Laboratory DirectorSteven M. Knapik
Laboratory Phone(909) 878-8000
Laboratory LocationHeritage Victor Valley Medical Group42002 Fox Farm Road Suite 201, Big Bear Lake, CA 92315
CLIA data matches this NPI record on: Name 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 Vvipa Medical Group Inc's NPI number?

The NPI number for Vvipa Medical Group Inc is 1295126001. It was assigned to this organization in the NPPES registry on February 16, 2015. The provider is doing business as Heritage Victor Valley Medical Group.

Where is Vvipa Medical Group Inc located?

Vvipa Medical Group Inc is located at 12370 Hesperia Rd Suite 6, Victorville, CA 92395. The listed phone number is (760) 245-4747.

What is Vvipa Medical Group Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Vvipa Medical Group Inc enrolled in Medicare?

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

How many clinicians bill Medicare through Vvipa Medical Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 27 clinicians in 8 Medicare specialties reassign their Medicare billing to Vvipa Medical Group 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. The largest specialties are Nurse Practitioner (11), Family Practice (7) and Internal Medicine (4). Of these, 5 practice at this address and 10 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Vvipa Medical Group Inc hold CLIA laboratory certificates?

Yes. 7 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Vvipa Medical Group Inc was last updated on February 27, 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.